As Rep. Pramila Jayapal gears up for a big rollout of her new Medicare for All bill at the federal level, the ambition to implement a Medicare for All system in Washington state has been reduced to a bill that would set up a work group.
To be fair to lawmakers who promised to champion state-based single payer during their campaigns, Congress seems to have no appetite for offering states the waivers they'd need to funnel Medicaid/Obamacare dollars into a state-based health care system. So, rather than continuing to bullshit their constituents about the possibility of instituting a state-based single-payer program tomorrow, they're coming out and acknowledging the fact that they're hitting some walls.
On Monday evening, state senator Emily Randall organized a small roundtable discussion (which she livestreamed on Facebook) to talk about the new strategy.
“We know that today we wouldn’t be able to get the Medicaid waiver from the federal government in order to adopt universal healthcare system overnight. That’s the reality in which we’re operating," said Rep. Noel Frame. The new goal, she said, is to put a structure in place that will be ready to implement single payer at the state level if Congress ever decides to grant the waivers.
"Work groups are actually a really good way to do that. It’s actually a gigantic step towards moving us to universal health care," Frame said.
Sen. Randall was open about how the practical demands of passing legislation in Olympia changed her expectations for action on this issue. “From an outside perspective, I thought that as soon as we had a big majority in the legislature we’d be able to push through the best policy right away," she said. "Now on the inside I understand the intricacies of ensuring that we can fund it, that we have the support, and that we are prepared for a sustainable solution, one that can’t get the rug pulled out from under it as soon as elections change, and as soon as we have different members of the legislature."
The new bill, Senate Bill 5822 / House Bill 1877, would convene a work group composed of consumers (i.e. sick people), large and small businesses, labor, doctors, hospitals, health insurance bureaucrats, representatives from state health agencies and finance agencies, and Democratic and Republican legislators from the state house and senate.
Together the group would "study and make recommendations to the legislature on a universal health care system that includes publicly funded, privately delivered health care that is sustainable and affordable to all Washington residents." The idea here is to show the legislature the pathway to "universal health care" in Washington state.
The group will explore ways to make a "just transition" to single payer, compare various financing mechanisms, examine possible transparency issues in order to determine why insurance and care cost so much, and consider the option of partnering with other states to create a regional single-payer system. The group must file its report and recommendations by November 15 of next year.
According to Sen. Randall, however, these recommendations won't be binding. "We can't bind a future legislature to the decisions we found, but it is our intent to move forward with the policies we find viable," she said.
Now there's one hell of a campaign slogan. Senate Democrats: It Is Our Intent To Move Forward With the Policies We Find Viable.
Anyhow, you might remember that lawmakers have already commissioned a study comparing the costs of implementing and transitioning to different models of universal health care. During the roundtable discussion, Rep Nicole Macri, who's sponsoring the bill in the house, said that study will be out in June. She added that the new bill gets "far more specific than the study that was commissioned," instructing the work group to focus on models the study won't include and identifying inefficiencies in the private health insurance market.
Unlike previous single-payer bills, this one has support from some of the more conservative Democrats in the Senate. Sen. Mark Mullet, the Democrat who blocked the singer-payer bill from passing out of committee last session, said he supports Randall's bill as a way "to look at other possible solutions," but that he supports Gov. Inslee's health care proposal as a way "to try and do something immediate this session." Inslee's plan, by the way, sucks.
Sen. Guy Palumbo, who endorsed state-based single-payer last session, also said he likes Randall's bill.
The bill will get a hearing in Ways and Means this Wednesday. Considering Sen. Mullet's support of the bill and the fact that Sen. David Frockt, the vice chair of that committee, is a cosponsor of the bill, chances are looking good that it will pass out of committee.
However, as Rep. Frame and Macri noted during the roundtable meeting, the bill will only get to the floor if constituents call their reps and politely demand that it happen. So, you know, if you're not doing much at lunch today, you might consider calling your representatives in the house and senate and asking them to support Senate Bill 5822 / House Bill 1877. And then you might politely urge them to move forward with the policies the work group finds viable at the end of next year, or else you will move forward with voting them the fuck out of office.