Universal health deadlines

AN ACT Relating to establishing deadlines for the universal 1
health care commission; and amending RCW 41.05.840.2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:3
Sec. 1. RCW 41.05.840 and 2021 c 309 s 2 are each amended to 4
read as follows: 5
(1) The universal health care commission is established to create 6
immediate and impactful changes in the health care access and 7
delivery system in Washington and to prepare the state for the 8
creation of a health care system that provides coverage and access 9
for all Washington residents through a unified financing system once 10
the necessary federal authority has become available. The authority 11
must begin any necessary federal application process within 60 days 12
of its availability. 13
(2) The commission includes the following voting members:14
(a) One member from each of the two largest caucuses of the house 15
of representatives, appointed by the speaker of the house of 16
representatives; 17
(b) One member from each of the two largest caucuses of the 18
senate, appointed by the president of the senate; 19
(c) The secretary of the department of health, or the secretary's 20
designee; 21
S-3573.2
SENATE BILL 5948
State of Washington 69th Legislature 2026 Regular Session
By Senators Hasegawa, Bateman, and Slatter
Prefiled 12/29/25. Read first time 01/12/26. Referred to Committee
on Health & Long-Term Care.
p. 1 SB 5948
(d) The director of the health care authority, or the director's 1
designee; 2
(e) The chief executive officer of the Washington health benefit 3
exchange, or the chief executive officer's designee;4
(f) The insurance commissioner, or the commissioner's designee;5
(g) The director of the office of equity, or the director's 6
designee; and 7
(h) Six members appointed by the governor, using an equity lens, 8
with knowledge and experience regarding health care coverage, access, 9
and financing, or other relevant expertise, including at least one 10
consumer representative and at least one invitation to an individual 11
representing tribal governments with knowledge of the Indian health 12
care delivery in the state. 13
(3)(a) The governor must appoint the chair of the commission from 14
any of the members identified in subsection (2) of this section for a 15
term of no more than three years. A majority of the voting members of 16
the commission shall constitute a quorum for any votes of the 17
commission. 18
(b) The commission's meetings shall be open to the public 19
pursuant to chapter 42.30 RCW. The authority must publish on its 20
website the dates and locations of commission meetings, agendas of 21
prior and upcoming commission meetings, and meeting materials for 22
prior and upcoming commission meetings. 23
(4) The health care authority shall staff the commission.24
(5) Members of the commission shall serve without compensation 25
but must be reimbursed for their travel expenses while on official 26
business in accordance with RCW 43.03.050 and 43.03.060.27
(6) The commission may establish advisory committees that include 28
members of the public with knowledge and experience in health care, 29
in order to support stakeholder engagement and an analytical process 30
by which key design options are developed. A member of an advisory 31
committee need not be a member of the commission. 32
(7) By November 1, 2022, the commission shall submit a baseline 33
report to the legislature and the governor, and post it on the 34
authority's website. The report must include: 35
(a) A complete synthesis of analyses done on Washington's 36
existing health care finance and delivery system, including cost, 37
quality, workforce, and provider consolidation trends and how they 38
impact the state's ability to provide all Washingtonians with timely 39
access to high quality, affordable health care; 40
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(b) A strategy for developing implementable changes to the 1
state's health care financing and delivery system to increase access 2
to health care services and health coverage, reduce health care 3
costs, reduce health disparities, improve quality, and prepare for 4
the transition to a unified health care financing system by actively 5
examining data and reports from sources that are monitoring the 6
health care system. Such sources shall include data or reports from 7
the health care cost transparency board under RCW 70.390.070, the 8
public health advisory board, the governor's interagency coordinating 9
council on health disparities under RCW 43.20.275, the all-payer 10
health care claims database established under chapter 43.371 RCW, 11
prescription drug price data, performance measure data under chapter 12
70.320 RCW, and other health care cost containment programs;13
(c) An inventory of the key design elements of a universal health 14
care system including: 15
(i) A unified financing system including, but not limited to, a 16
single-payer financing system; 17
(ii) Eligibility and enrollment processes and requirements;18
(iii) Covered benefits and services; 19
(iv) Provider participation; 20
(v) Effective and efficient provider payments, including 21
consideration of global budgets and health plan payments;22
(vi) Cost containment and savings strategies that are designed to 23
assure that total health care expenditures do not exceed the health 24
care cost growth benchmark established under chapter 70.390 RCW;25
(vii) Quality improvement strategies; 26
(viii) Participant cost sharing, if appropriate;27
(ix) Quality monitoring and disparities reduction;28
(x) Initiatives for improving culturally appropriate health 29
services within public and private health-related agencies;30
(xi) Strategies to reduce health disparities including, but not 31
limited to, mitigating structural racism and other determinants of 32
health as set forth by the office of equity; 33
(xii) Information technology systems and financial management 34
systems; 35
(xiii) Data sharing and transparency; and 36
(xiv) Governance and administration structure, including 37
integration of federal funding sources; 38
(d) An assessment of the state's current level of preparedness to 39
meet the elements of (c) of this subsection and steps Washington 40
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should take to prepare for a just transition to a unified health care 1
financing system, including a single-payer financing system. 2
Recommendations must include, but are not limited to, administrative 3
changes, reorganization of state programs, retraining programs for 4
displaced workers, federal waivers, and statutory and constitutional 5
changes; 6
(e) Recommendations for implementing reimbursement rates for 7
health care providers serving medical assistance clients who are 8
enrolled in programs under chapter 74.09 RCW at a rate that is no 9
less than 80 percent of the rate paid by medicare for similar 10
services; 11
(f) Recommendations for coverage expansions to be implemented 12
prior to and consistent with a universal health care system, 13
including potential funding sources; and 14
(g) Recommendations for the creation of a finance committee to 15
develop a financially feasible model to implement universal health 16
care coverage using state and federal funds. 17
(8) Following the submission of the baseline report on November 18
1, 2022, the commission must structure its work to continue to 19
further identify opportunities to implement reforms consistent with 20
subsection (7)(b) of this section and to implement structural changes 21
to prepare the state for a transition to a unified health care 22
financing system. The commission must submit annual reports to the 23
governor and the legislature each November 1st, beginning in 2023. 24
The reports must detail the work of the commission, the opportunities 25
identified to advance the goals under subsection (7) of this section, 26
which, if any, of the opportunities a state agency is implementing, 27
which, if any, opportunities should be pursued with legislative 28
policy or fiscal authority, and which opportunities have been 29
identified as beneficial, but lack federal authority to implement.30
(9) By December 1, 2027, the commission shall submit a report 31
with its final recommendations for a universal health care system, 32
including eligibility, benefit design, provider reimbursement, 33
financing, governance, and any other component necessary to implement 34
the system.35
(10) By December 1, 2028, the commission shall establish the 36
following advisory committees:37
(a) A finance committee consisting of financial experts from the 38
office of financial management, the office of the state treasurer, 39
the employment security department, and the office of the insurance 40
p. 4 SB 5948
commissioner. The finance committee shall recommend specific details 1
for major budget decisions and for appropriations, taxes, and other 2
funding legislation necessary to conduct the operations of a 3
universal health care system; 4
(b) A citizen committee consisting of balanced representation 5
from people with relevant knowledge in health, business, labor, 6
tribal governments, disability needs, body size, and consumers, 7
specifically including representation from populations where health 8
care disparities are known to exist. The citizen committee shall hold 9
public hearings on priorities for inclusion in the set of health 10
services to be offered in a universal health care system, survey 11
public satisfaction, investigate complaints, and identify and report 12
on health care access and other priority issues for residents; and13
(c) A provider committee consisting of members with broad 14
experience in and knowledge of health care delivery, research, and 15
policy, as well as public and private funding of health care 16
services. The provider committee shall make recommendations to the 17
commission on issues related to scope of covered benefits, quality 18
improvement, continuity of care, resource utilization, and other 19
issues as requested.20
(11) By December 1, 2029, the commission shall draft legislation 21
to establish a universal health care system in the state. The 22
legislation must meet the objectives for a universal health system as 23
set forth in this section and Senate Joint Memorial No. 8004 (2025).24
(12) Subject to sufficient existing agency authority, state 25
agencies may implement specific elements of any report issued under 26
this section. This section shall not be construed to authorize the 27
commission to implement a universal health care system through a 28
unified financing system until there is further action by the 29
legislature and the governor. 30
(((10))) (13) The commission must hold its first meeting within 31
90 days of July 25, 2021. 32
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