Last Wednesday was the final day for bills to make it out of their house of origin in the Washington State legislature. While many bills still in play are worth paying attention to, I want to focus on a pair that didn’t make the cut: Senate Bill 5233 and House Bill 1445.
Both bills would have created the Washington Health Trust (WHT), a system of universal healthcare for the residents of our state. Introducing universal healthcare bills to both houses in the same session is a first, and these bills enjoyed unprecedented support. Efforts to enact universal healthcare at a state level have been underway in some form since 1993, but this year the bills received a record number of cosponsors in each chamber—11 in the Senate and 17 in the House—plus the endorsement of the Washington State Democratic Party.
Our state has a Democratic trifecta, meaning that the committees that both bills needed to pass through—Health & Long-Term Care in the Senate and Health Care & Wellness in the House—are chaired by Democrats. In this case, Sen. Annette Cleveland (D-Vancouver) and Rep. Dan Bronoske (D-Lakewood). Universal healthcare has been a part of the Washington State Democratic Party’s platform for almost a decade.
The bills also arrived at a time when our country’s system of private insurance is at an all-time low in popularity. Conversely, the concept of universal healthcare is polling better than ever. Our state’s bills would do exactly what has made universal healthcare such a popular idea: provide comprehensive coverage to all residents of Washington State at low or no cost.
So, if everyone loves universal healthcare and all the politicians involved say they do too, why the hell didn’t it get a hearing?
“That’s a question I’ve been asking since 2016,” said Andre Stackhouse, the executive director of Whole Washington, one of the groups behind the WHT bills.
“I wish I could say that I was surprised that the bills didn’t get a hearing this year,” he said. “We have worked very hard to establish something of a dialogue and a working relationship with Chair Cleveland, but this is something she’s held firm on ever since she was elected chair.”
This year, at least, she offered some explanation as to why. In response to a letter from Healthcare is a Human Right Washington (HCHR-WA) that went to her and Rep. Bronoske, she wrote:
“Regarding your request for a hearing, I have been clear in all discussions that Senator Hasegawa’s Washington Health Trust bill, SB 5233, would not be heard this year because I am not willing to disingenuously give advocates hope by hearing a bill that will not be moved out of committee. We are facing very dire budget shortfalls as a state this year that prevents bills with large fiscal notes from moving forward. In addition, it is premature to consider SB 5233 when we still face the roadblock of the federal government in preventing implementation. Finally, the work of the Universal Health Care Commission must be more fully completed before any policy is considered.”
Earlier in her response, she told advocates copied on the email, “Be assured that I am a continued strong advocate of our shared goal.”
While one might expect a strong advocate of state-level universal healthcare to advance a bill that would create such a system out of the committee she controls, she went on to list several things she is doing instead of that.
One was to join Sen. Bob Hasegawa (D-Seattle), one of SB 5233’s cosponsors, in writing a letter to the Universal Health Care Commission asking them to study SB 5233 and develop recommendations for future legislation. Never mind that the bill is pretty finely tuned already. The other was to wait on passage of Rep. Hasegawa’s Senate Joint Memorial 8004, a nonbinding resolution that would ask the federal government very nicely to let us do universal healthcare.
Democrats are once again gearing up to tell us that better things are not possible, and they really like sounding like the voice of reason when they do it. “Just wait, we’re working on it, someone else is stopping us, these things take time.” But is this actually reasonable? Let’s take a closer look.
First off, while the Universal Healthcare Commission (UHCC) is still studying the issue and plans to issue a final report that could potentially inform future legislation, it is by no means opposed to the WHT.
“The UHCC has published their Washington Health Trust Analysis Report and found that it aligns with their universal health care system design,” HCHR-WA wrote in its letter. Saying we need to wait for the UHCC to wrap up is something of a stalling tactic here, it seems.
Second, it is not fiscally irresponsible to enact universal healthcare. Not enacting universal healthcare is, in fact, the fiscally irresponsible choice, according to HCHR-WA’s letter:
“The Washington Health Care Authority’s Work Group Report has also estimated that a system like the WHT would potentially save $800 million to $2.5 billion in an implementation year, and up to $5.6 billion on an annual basis in total health care spending once its transition is complete. The WHT raises all necessary revenue and will result in savings for the state across other sectors like housing and law enforcement. In a year in which the state is experiencing significant budgetary challenges, revenue and savings like these may be necessary to implement the budget.”
It might sound preposterous that making the state responsible for all Washingtonians’ healthcare costs would pencil out, but there would be plenty of money coming in. The WHT’s coverage obligations would be backed by a lot of new revenue, specifically in the form of taxes on business and capital gains.
Employers would pay a new 4.5-10.5 percent tax on wages, while sole proprietors would pay 2 percent of earnings. Investors with capital gains of over $200,000 would pay 5 to 9 percent of their profits. For capital gains exceeding $300,000, they’d pay an extra 2 percent. However, profits from home sales or retirement accounts would be exempt, as would capital gains reinvested in a primary residence.
“[The cost is] very similar to the current system where the employers pay premiums and they usually share those premiums with the employee,” Stackhouse said. “I think for most people [it’s] very competitive compared to what they’re paying.”
Several studies have shown that the only people who pay more under a system like the WHT are people in the top 1 percent of earners.
“It’s really only incomes above, I think, $500,000 that pay significantly more,” Stackhouse added. “And the biggest, biggest impact is [in favor of] the working and middle class who right now pay the highest percentage of their income on healthcare.”
While there is no federal law explicitly preventing states from setting up universal healthcare systems, to make such a system work, states would need to use the money they get from the federal government for Medicare and Medicaid to cover the cost. To do that, they need a waiver allowing them to apply that money to the WHT. If a state enacts a universal healthcare plan and then approaches the Department of Health and Human Services only to be denied, it could leave you in quite a bind. States are required to balance their budget every year, and if they’ve suddenly taken on the cost of covering all residents while losing a major revenue source earmarked for that purpose, they won’t be able to balance shit.
“They are in financial peril,” Stackhouse said, referring to programs that cover low-income residents like Medicaid or Cascade Care. “So even just to save existing programs, we need to talk about raising revenue.”
So if it’s not really about cost, because it might actually save us money, and it’s not really about federal barriers, what is it about? You could point to a lot of more, shall we say, transactional reasons why Sen. Cleveland continues to table the bill — her 2024 campaign donor list is chock full of large insurers, pharmaceutical companies, and healthcare industry associations, as is Rep. Bronoske’s — but let’s examine what Sen. Cleveland said about not getting anyone’s hopes up.
Cleveland is not wrong about the barriers something like the WHT faces, whether legislative or logistical. Getting away from the miserable, bloodsucking system of private insurance that we have now takes time. Private insurance won’t go away overnight or perhaps ever (nor is it intended to under the WHT). Funding for universal healthcare might get pulled out from under us like a rug. The deranged fascists in charge of the federal government might come down even harder than that, denying funding for other things until we give up our silly notions of socialized medicine. Right now, we have no way of knowing what would happen if the WHT was enacted into law.
But part of why we don’t is because we haven’t done it. We’ve known it’s the right thing to do for decades and now, when we have a viable plan to do it, the people who are supposed to be fighting for us are stalling.
Full disclosure: If I come off biased in favor of these bills, it’s because I am. I have lived with type 1 diabetes for almost 15 years. I have navigated every nook and cranny of the private insurance landscape. I have paid thousands of dollars, even while insured, for the simple privilege of being alive. And I’m lucky to have been able to stay insured. Without coverage, financial ruin comes to most diabetics in a matter of months.
Frederick Banting invented insulin in 1921 and sold the U.S. patent for it for $1, with explicit instructions to make it cheap and widely available.
“Insulin does not belong to me, it belongs to the world,” he said.
It now belongs to three massive pharmaceutical companies and costs $300 a vial. It costs them $2 to make that vial. If we lived in a just society, the price-fixing ghouls who have created this reality would face consequences.
When it comes to hope, I would say it’s too late. I already have hope. I hope every day for a system that doesn’t do this to people. But every day I see people in power preserve a system that actively does this to people — that causes medical bankruptcies and denies claims and drives people to ration their insulin until they fucking die — and my hope turns into anger.
In this case, I think anger is very appropriate. I think we should all be very, very angry that anyone allows this insane, criminal system to continue. I think that no matter our political affiliation, we should be asking anyone who wants to represent us what they really mean to do for us. And when. Are they willing to stand up to their donors? Or better yet, are they willing to forego donations from the people they’re charged with regulating? Are they on our side? If not, well, the word primary is also a verb.
So what’s next for Washington’s Universal Healthcare dream? Whole Washington, the group behind the WHT, is not giving up so easily. They’re currently building towards a ballot initiative in hopes of running one soon. Despite what Brian Heywood thinks, they’re not only for billionaires to buy policy. and if you want to put the ballot initiative back in the hands of the people, Whole Washington would love your help.
I don’t want universal health care. Why? I grew up with it. Fu*king nightmare of shortages, waitlists and mediocre care. I get much better healthcare in the US.
Signed,
Lived Experience Matters
I really like my employer mandated health care (universally required, but not what Americans think of as socialized medicine).
I pay a lot for it based on my salary but my employer pays their half.
And when things go sideways, I don’t have to worry about paying for it. And things go sideways more often than not.
Do I have to wait in a waiting room for care, yes. But everyone does it, I don’t expect anything special. Do I get specialist care when required, yes, I do.
The US does have the best care in the world. But it is horribly distributed and costs an arm and a leg, or your house and savings. Employer mandated or socialized medicine is not as stellar, but the results speak for themselves. You live longer, on average, if you live in a country with either mandatory or socialized health care.
My experience has been brain surgery on short notice with a copay of 100 local currency units for 10 overnights and the partner getting medicine that costs 20,000 local currency units annually on the ‘free’ market for nothing because it is considered essential.
I’m sorry your parents were halfwits that were unable to navigate the healthcare system of whatever country you came from Simon dear. That must have been difficult for a wan and unhealthy child who needed a lot of care.
I wish you good health if you are living here in the US, because you’re going to need it.
“So, if everyone loves universal healthcare and all the politicians involved say they do too, why the hell didn’t it get a hearing?”
Same reasons as always: everybody loves universal healthcare in the abstract, and then they hate it when you get specific about how to implement it. The article just sorta glosses over the fact that the plan to pay for it is an income tax — which lost 36/64 when on the ballot in 2010, with every county in the state voting no. King County voted 54% no!
The devil is in the details. It does no one any good to pretend otherwise.
“[Insulin] now belongs to
three massive pharmaceutical
companies and costs $300 a vial.
It costs them $2 to make that vial.
If we lived in a just society,
the price-fixing ghouls
who have created this
reality would face
consequences.”
but we live
in a Sociopath-
Controlled world.
a world where Half the
Citizenry is (a) considered
chattel (women)* or (b) here
solely for sociopaths to farm, strip-
mine andor Harvest till any sense of
Humanity’s been removed and we see
each other as profit centers or leeches or
kings or Gods or Whateverthefuck to Rule
Us howsoever THEY may Happen to see fit.
there ARE
Better
Mod-
els.
*thanks,
Patriarchy!
women don’t
‘need’ any Agency
that’s why the
Menfolk’re
Here — to
tell ’em
What
to Do.
@3
if
wishes
were horses
there’d be a Stampede
kristofarian dear, we had thirty dollar insulin under “Genocide Joe”. But our purity voters put an end to that.
Speaking of that, it looks like trump and Netenyahu are forging ahead with clearing land (and people) in Gaza to build our generation’s Beirut Holiday Inn.
@7 Bingo.
@6 “it’s all the voters’ fault” excuse is a sure way to lose the next election
Ta-Nehisi Coates: “If Democrats can’t draw the Line at Genocide, they can’t Draw the Line at Democracy”
https://www.juancole.com/2025/02/democrats-genocide-democracy.html
“Coates said he was convinced that there was some way in which the Democratic Party’s support for the Gaza genocide cost it the election — not, he said, necessarily in a demographic sense, but in a moral sense.
I think he was implying that the party did not seem to stand for anything. He said he attended the Democratic Party Convention last year, and noted the praise heaped on prominent African-American leaders of the past and present. But, he said, everybody knew that one group would be excluded from these paeans. “
@our ever-Delighful Catalina:
& dancing
on their Graves
will soon be A Thing.
Dems EXPECT Votes
their Entitlement
knowing no
bounds
rushing to the Center
trying to Keep Up’s
gonna Doom
the USofA
but
fuck
Yeah
Blame
Progressives.
owning the Media
capturing the Lingo*
weaponizing culture issues +
Citizens Fucking United has End-
ed our little Experiment in Democracy
and they’ve got us
at each other’s
throats.
*see also:
Wormtongue
Before this completely swerves into another discussion about how the D’s would have won if only they had embraced a terrorist organization let’s circle back to the main plot. @4 has it correct but I’d take it a step further. While universal care may be better in aggregate the other issue you have is you are going to ask those that have great care right now via their employers (think Microsoft et al) to reduce the standard of care they are receiving today while paying more for it so that those at the lower end of the spectrum will have enhanced coverage. That’s noble but it goes against everything we know about human nature. Beyond that I don’t believe the cost calculations are correct either. The author is assuming demand for care will be the same as it is today which will not be the case. Today care is triaged via cost so when people can’t afford care they don’t seek it. If you remove the cost the demand for care will skyrocket as will the costs to provide such care. I understand in the long run it may reduce the overall costs of care by preventing issues early but the fact remains in the first decade or so the costs of establishing universal health care will be enormous.
AverageBob dear, am I running for office, or have I been appointed to some position of leadership in the Democratic Party? If not, I don’t see how Little Me expressing my opinion is going to lose any elections.
“another
discussion about how
the D’s would have won if
only they had embraced a terrorist organization”
fuck
You you
dishonest
piece of shite.
Israel’s
raining
Terror right
fucking Now
on Palestinians.
on
OUR
tax dollars!
@12 As it were, the Democratic party should advocate policies agreed upon by its base, like universal healthcare or no unconditional support for Israel or … (ad infinitum), but the people in charge decided otherwise.
democratic
in name
Only.
@6 “we had thirty dollar insulin under “Genocide Joe”. But our purity voters put an end to that.”
No “we” didn’t, only people who got it through Medicare parts B or D. So only a subset of people over 65. You probably just assumed that Biden and the Dems had secured $30 insulin for everyone because that would be the moral, and widely popular, thing to do. But they didn’t.
Canadians have it good health care, and they can come to the US for quicker treatment if needed.
You’re correct, thirteen12 dear. I remembered that after I posted it.
But now no one has thirty dollar insulin. Let’s hear it for equality!
@20 no, that’s also not correct, all the same people still have $35 insulin:
https://www.reuters.com/fact-check/insulin-cap-medicare-unaffected-by-trump-order-prescription-drug-costs-2025-01-28/
@1 How much did you pay out of pocket for those ‘nightmares’? The US has all those nightmares too but we have the privilege of going broke when we seek care.
That better care you’re receiving in the US? Don’t count on it. You’re just as susceptible to a denial or exorbitant change as anyone else. I have no idea why you’d feel smug about the quality of care here.
But hey, if you love what you’ve got lol, keep it. The rest of us prefer not to enrich a parasitic industry that provides no service whatsoever.
Single payer polls great when it is generically presented as “free” healthcare for all, but when the details of implementation are revealed support collapses. There is no better illustration of this than the failure 10 years ago of single payer in Bernie’s home state of Vermont, which should serve as a cautionary tale for anybody still pushing this idea. Here’s a good look at that effort, and how it all fell apart, from WaPo:
“Why Vermont’s single-payer effort failed and what Democrats can learn from it”
https://wapo.st/3XZrKIN
(this link should get by the paywall for those who don’t subscribe)
They should enjoy the inexpensive insulin while they still can. I’m sure Elon will not be feeling the need for it.
@4, @11, @23 get it.
People’s opinions about universal healthcare are highly contextual. You’ll find that many of the truths they cling to depend greatly on their point of view. Survey questions are tailored to create a context that gets the desired response.
As you move out of those abstract survey questions and into the real trade offs and costs of switching, support breaks down. Now add to that risk calculus the possibility of a future R governor with his own mini Elon and WADOGE with the ability to fuck with everyone’s healthcare…
The widespread support just really isn’t there, and the advocates are getting played by the progressive politicians because the advocates got on the wrong side of the issue that most determines their vote.
@18, 21 — your commitment to supporting Donald Trump and trashing anything the Democratic Party does continues unabated.
Bax dear, some people never move beyond the Angry Undergraduate phase.
District13, I believe the original intent of Medicare was to gradually lower the eligibility over the course of several decades (open it to sixty and older, then fifty-five and older, etc). That was to help smooth the transition pains that you describe, but the insurance companies and the AMA screamed bloody murder so that never came to fruition.
“In this case, I think anger is very appropriate. I think we should all be very, very angry that anyone allows this insane, criminal system (profiteering off the Citizenry’s Lives) to continue.”
This is what we get
when we allow a ‘citizens
united’ decision to overule
our Democracy: corporate rule.
oh & a djt.
Sure.
When the business and capital gains taxes prove to be inadequate, the left wingers will be begging for a property tax increase.
Washington has poured billions into the homeless industry and has very little show for it. Why would anyone think they could successfully and efficiently manage healthcare.
“Why would anyone think
they (we) could successfully
and efficiently manage healthcare.”
bingo. if only We
were as Smart as
the Civilized World.
This is single payer healthcare, WA’s already has an ecosystem after Medicaid expansion in ACA with close to universal healthcare availability, You either get it through work, or if you don’t can go through the incredibly easy Apple care enrollment process, or you have Medicare, or if you’re in a unique situation where you’re a contractor and make below many income thresholds you can buy your own in the exchange with government subsidies. The only real slip throughs left are high income independent contractors or high income self-employed who don’t qualify for exchange subsidization.
District13, your idea of “triage” – where people just don’t seek treatment unless they really need it naturally leading to less money being spent on healthcare – may seem to be the case until untreated symptoms result in Emergency Room visits. Untreated medical issues can result in higher treatment costs in a lot less than a decade, as you seem to infer. Also savings can be found by cutting out the profit-sucking insurance industry. United Healthcare for one had profits of about $90 Billion last year.
As stated in the article, not enacting universal healthcare is the fiscally irresponsible choice. For more information on how it would be funded, check out https://wholewashington.org/how-we-pay-for-it/
We could get rid of gatekeepers, for-profit insurance administration, and having to stay “in-network.” Most of the developed world’s countries are doing it. The US spends more per capita for healthcare with worse outcomes for us all. It is beyond disappointing that some of our state’s politicians can’t seem to understand that and take action.
@30
It’s awfully generous to think the people of Washington are smarter or even as smart as the rest of the world.
Homelessness runs rampant, despite having poured billions into it.
Crime runs rampant, but some genius wants to see child murderers get out of jail as long as they kill 2 or less people.
Deaths due to opioids runs rampant, but the state decriminalized drug use, then pretended to be shocked when people kept dying.
Nearly a third of high school graduates don’t read above a 3rd grade level
Washington isn’t as smart as it thinks it is.
“provide comprehensive coverage to all residents of Washington State at low or no cost.”
Awwww… but that’s not how it actually works. It’s not low or no cost; the cost is just shoved onto your taxes. That’s not low or no cost at all.
Hmmm…
“Our state’s bills would do exactly what has made universal healthcare such a popular idea: provide comprehensive coverage to all residents of Washington State at low or no cost.”
No, it’s not coverage for low or no cost. It’s paid for through each resident’s taxes. That’s not “low or no cost”.
sigh So apparently caching is a little aggressive on this website…
@4 But this is offset because the employer doesn’t have to pay for insurance which is far more expensive.
It’s not only reducing costs because of the preventive aspects, @11, but the treatable aspects as well, along with the point that you’re taking the profit motive out of the equation. Our own non-partisan CBO has repeatedly found that a national single payer health care plan would be the most cost-effective way to provide quality health care to every American. So it’s just not true what you’re asserting.
When the U.S. started out on its current disastrous course under Nixon, Canada was starting single payer, and at that time, our nations were health care twins. Yet in only the 35 years, the Canadians were greatly outpacing us in terms of costs and health care outcomes.
https://shorturl.at/OM4hi
Also, when we were trying to get single payer in 2008-2009, and we got the ACA instead, at that time, we ranked an abysmal 37th. Now after 16 years of the ACA, we are an abysmal 69th. Plus the death rates because of under or uninsurance have risen from about 68,000 annually to over 100,000; and annual bankruptcies because of medical bills go anywhere from 600,000-800,000 per year. It’s a leading cause of homelessness, too.
And now we have the Luigi Mangione case – a man who is presumed innocent, IMO – but even if he didn’t do it, he is widely perceived as a Robin Hood of sorts – heroic, instead of criminal – because so many Americans view these insurance CEOs as the real criminals, extortionists and racketeers, mass murderers, and the real death panels in our society.
Health care is a human right and it should not be treated as a commodity. It’s long past time we joined most other 21st C nations and guaranteed health care for all.
1 in 5 Americans, at present, would like to secede to Canada. How much you want to bet it has a lot to do with their excellent single payer system which is soon adding dental, as well.
And one of the Canadian officials – partly on provocation by Trump – actually invited, basically, the entire west coast from California through Washington, to come and become part of Canada. . . which they themselves said, would include their single payer system.