Washington lawmakers tackled a wide range of health care issues during this year’s legislative session, from staffing shortages to long-term care obstacles, and made some strides in addressing ongoing equity gaps within hospitals and health systems.
But more work is needed to smooth out solutions to some specific worker and patient safety concerns, like how to better support the state’s chronically understaffed hospitals and overworked staffers.
Many mental and behavioral health advocates also came away from the 2022 session wishing more had been done to expand roles for social workers, therapists and psychologists, though the new supplemental state budget, approved Thursday evening, allocates more than $100 million to help address behavioral health workforce shortages.
And as the world enters its third year of the COVID-19 pandemic, lawmakers also set aside more than $1 billion in unspent federal relief to help stabilize school districts and strengthen the hospitality and convention industries, the arts sector, and small businesses.
Millions will also be put toward cancer research, updating public health data systems, addressing the state’s opioid epidemic, building out more health insurance coverage options and tobacco-use prevention.
Here’s what Washingtonians should know about this year’s top health care bills and what new policies to keep an eye out for.
COVID response
Democratic lawmakers this week announced a state budget deal that would use more than $1 billion in remaining federal coronavirus aid, including $345 million to stabilize school districts and $215 million for the hospitality and convention industries, the arts sector, and small businesses.
The new supplemental budget also includes $125 million for the state’s ongoing pandemic response, including for vaccine distribution, diagnostic testing, disease surveillance and community outreach.
An additional $1.6 billion will be put into a special disaster-response account intended to help with ongoing pandemic recovery for families, schools and businesses.
Meanwhile, a bill that would end Gov. Jay Inslee’s declared COVID state of emergency never made it out of committee, nor did a set of bills that would have restored employment to those who were fired or resigned due to COVID vaccine mandates.
Hospital/nurse staffing
One of the most hotly debated health-related bills this legislative session opened another conversation on the state’s staffing shortages but ultimately didn’t make it through the Legislature. House Bill 1868 would have established new staffing standards, including a mandated nurse-to-patient ratio, better enforcement of meal and rest breaks, and an end to mandatory overtime policies, among other rules.
The state’s three largest health care worker unions fought to keep the bill alive in hopes of improving retention and workplace safety, but hospital leaders and executives opposed the legislation, saying it would have forced health care systems to delay care, eliminate some services or turn patients away.
“By not passing safe staffing standards this session, a handful of lawmakers have allowed hospital executives to continue putting profits above patient care,” leaders of the Washington State Nurses Association, SEIU 1199NW and UFCW 21 wrote in a joint statement this week. “But we’re not giving up. We’ll continue to fight for safe staffing standards, whether in the legislature, at the bargaining table, or on the ballot.”
House Bill 2007, which plans to help nurse educators with their student loans, did make it through the Legislature and will aim to encourage more people to pursue nurse teaching degrees, Rep. Eileen Cody, chair of the House Health Care & Wellness Committee, said in a statement last month.
“Currently, there are 6,000 fewer nurses in the state than we desperately need, but colleges that teach nursing cannot enroll enough new students to close the gap due to the lack of nurse educators available to teach them,” wrote Cody, D-West Seattle.
The bill establishes the nurse educator loan repayment program under the Washington Health Corps, which also runs a separate program that offers loan repayment help for health care workers who agree to practice in a “shortage area” — where health care professionals are in short supply — for at least three years.
Health equity
Washingtonians will soon see changes to the state’s charity care law, which promises free or discounted medical care to low-income patients. The Legislature this week passed House Bill 1616, which requires large hospital systems to provide more financial assistance and increases eligibility for discounts and full write-offs of out-of-pocket hospital costs.
Beginning July 1, about half of all Washingtonians will be eligible for free or discounted care at hospitals that house roughly 80% of licensed beds.
Under the state’s current charity care law, those with a household income at or below 200% of the federal poverty level are eligible for charity care. Now, anyone within 300% of the federal poverty level will be eligible for medical financial assistance.
“Under current law, a single parent working two minimum wage jobs at 50 hours per week was not eligible for financial assistance at Washington hospitals — that’s not right and it needed to change,” state Attorney General Bob Ferguson said in a statement this week.
Legislators also took steps to tackle issues of insulin affordability by passing Senate Bill 5546, which lowers some copayments for the hormone from $100 per month to $35 per month. Diabetes advocates have said the legislation could do more to address the larger reasons for high insulin prices — like complicated insurance plans — but many were still in support of the measure and celebrated its passing.
The law will go into effect Jan. 1.
The state’s birth doulas, who provide physical and emotional support before and after pregnancies, also celebrated a significant victory with the passage of House Bill 1881, which will allow doulas to apply for state certification and get Medicaid reimbursement.
The bill will increase access to birth doulas and work to close equity gaps in perinatal care, particularly among Black and Indigenous communities, who have been disproportionately harmed by perinatal mortality rates, bill supporters have said.
Long-term care
Legislators this session solidified changes to several of the state’s long-term care services and programs, including amending a controversial section of the WA Cares Fund.
Inslee signed House Bills 1732 and 1733 in January, a day after Senate lawmakers voted them out of that chamber. The new laws will delay the WA Cares payroll tax on Washington workers and expand the number of people who can seek permanent exemptions to avoid paying into the program.
The fund was passed in 2019 as a social insurance program that helps people with difficulties living on their own pay for a swath of services, like transportation and meal preparation, nursing care, and assisted living.
The program is funded by a 0.58% payroll tax on state employees, which was set to begin at the start of the year, but is now delayed until July 2023. The delay is seen as a win for those with concerns that certain people will pay into the program but might never see benefits.
“By allowing this extension, access to long-term care becomes more accessible to individuals who are closer to retirement,” Cody wrote in a statement last month.
The final supplemental budget also includes funding that addresses barriers to discharge — which have blocked hospitals from discharging patients who no longer need a hospital bed but still require some type of long-term care.
The $548.7 million that’s been set aside to help patients transition out of acute care was “greatly enhanced” by Inslee’s hospital staffing initiative, which he announced in January.
“This is not only better for the patients who are otherwise stuck in hospitals, but it frees up hospital resources for patients needing acute care,” Zosia Stanley, vice president and associate general counsel of the Washington State Hospital Association, said in a statement.
She continued, “With the ongoing response to COVID-19, hospital resources have proven especially precious.”
Information from The Seattle Times archives was used in this story.