- Q. How much will this new system cost?
- Q. Will I be covered if I get medical treatment outside the state?
- Q. Will vision & dental be covered?
- Q. Will I be covered even if I am unemployed?
- Q. Why pay for an economic analysis?
- Q. For current Medicare recipients, covered for Part B under a retiree plan from their former employer, how would coverage and costs change under single-payer?
- Q. Will I have to pay co-pays or out-of-network fees?
- Q. Will children be covered and will I have to play more to get my kids on this insurance plan?
- Q. How will you ensure that doctors and hospitals take the universal health insurance you're proposing? Will the reimbursement rates be higher than under the current Medicaid or Medicare system?
- Q. I have private insurance now. How will my employer-based health care be affected?
- Q. Will this cover hospice (long term care)?
- Q. My current insurance covers acupuncture at 16 visits/year as well as massage, chiropractic, and naturopaths. What coverage will single-payer provide for these important natural modalities?
- Q. When will Whole Washington receive an initiative number?
In 2019, we are projected to spend nearly $80 billion on healthcare in Washington state alone under our current system. According to Dr. Gerald Friedman’s economic analysis, a universal public health insurance covering all essential health benefits would cost less than $70 billion, eliminating more than $10 BILLION in healthcare costs for Washington state residents. Yes, you read that correctly: it will SAVE Washington residents more than $10 billion!!! The savings isn't the only perk though.
Universal health public insurance saves on every aspect of federal and state funded healthcare administrations so the program has more money to fund healthcare. It minimizes the costs associated with provider administrative, insurance administration, fraud, and reducing the costs of prescription drugs by negotiating a better deal for everyone enrolled.
The benefits package would cover all essential healthcare, guarantee choice of provider, and nearly all out-of-pocket expenses giving Washington residents access to the healthcare they need when they need it. More people covered, more care and we still save money.
The Board is instructed to make provisions for reimbursing qualified providers who provide services to enrolled individuals while they are temporarily out-of-state.
The provider would have to participate in negotiating and receiving payment for the covered services you receive. However, all providers who are qualified to provider covered services will be eligible to participate in the program. The single payer system will negotiate essential healthcare costs with any qualified provider on behalf of everyone enrolled. Unlike for-profit insurance, it will be managed by a single entity that actually cares about the health and well-being of residents over profit margins.
Yes, dental and vision will be covered.
Yes. All residents earning under 200% will be covered whether they are employed or not.
In order to put the necessary funding mechanisms in the initiative, Whole Washington needed to know how much the system would cost. Dr. Friedman has done these studies for many different states, to include in those states’ bills and initiatives. Without this study, the campaign would have been exposed to the criticism that there is no funding and detractors could have used it as an opportunity to come up with their own projections. This happened recently in California and was the excuse some used for not pushing the Single Payer bill out of committee.
Q. For current Medicare recipients, covered for Part B under a retiree plan from their former employer, how would coverage and costs change under single-payer?
If you're currently eligible for Medicare or most other federal programs, you'll be eligible to enroll and subject to the premium if your income is 200% of the FPL or more prior to federal funding waivers for each program and if you earn income through an employer operating in Washington, your pay will be subject to the health risk assessment. For Medicare, your enroll in the plan the same way you enroll in a Medicare Advantage plan prior to waivers being approved. Once waivers for these programs federal funds are granted these individuals wouldn't be subject to the premium, a lower premium, or the board could lower everyone's premiums for adults over 200% based on the administrative savings from integration of each program.
No out of network fees will be levied under the current plan. Premiums will not exceed $200 per month for each adult in a household earning 199% of the federal poverty level. The premiums can be paid by employers, residents, or their spouse.
Households with adults with income over 199% of the federal poverty level will also be subject to co-pays for prescription drugs intended to encourage generic use and which would be limited to a maximum of $250 annually.
All Children under the age of 19 will be covered under Whole Washington’s universal healthcare initiative with no premiums or out-of-pocket costs.
Q. How will you ensure that doctors and hospitals take the universal health insurance you're proposing? Will the reimbursement rates be higher than under the current Medicaid or Medicare system?
The universal health trust will negotiate with all qualified providers in one of two ways:
Community Health Providers - Any facility that is non-profit with five or more coordinating practitioners who elect to negotiate global budgets based on regional health needs and quality measures. This will be a more stable and appealing reimbursement option for many providers.
Fee-for-service - Any qualified provider will be able to negotiate collectively for reimbursement rates. Our study predicts that providers will be able to negotiate rates about 1-5% higher than Medicare.
Employers are averaging 12% of payroll for employee coverage currently. Our plan allows employers who offer ACA compliant coverage to employees to opt out of the health risk assessment for those employees during transition. However, the fiscal study indicates that 8% to 8.5% with an exemption on up to $15,000 in pay annually per employee. This will be an appealing option and many employers will simply be relieved to have a less expensive (and potentially free) option. Additionally during transition, employees will be able to opt in and decline their employer coverage by paying the health risk assessment on their pay themselves. Once 51% of residents in the state are enrolled in a state administered health insurance, employers will no longer be able to opt out of the health risk assessment.
Our Initiative doesn't restrict employers from offering additional insurance coverage or resident from purchasing additional insurance coverage.
Yes, Hospice and end of life care services will be covered.
Q. My current insurance covers acupuncture at 16 visits/year as well as massage, chiropractic, and naturopaths. What coverage will single-payer provide for these important natural modalities?
The universal healthcare trust created will have to cover at least the coverage required for our states “benchmark health plan” in order to qualify for federal funding. Here is our state’s current benchmark coverage: https://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/Updated-Washington-Benchmark-Summary.pdf
Additional coverage may be considered essential by our trust based on medical evidence and provider feedback.
Washington state is a leader in natural care modalities, being home of Bastyr University, one of only four [5 or 6: Bastyr (Seattle), Bastyr (San Diego), National U of Natural Medicine (Portland), SW (Phoenix), National U. of Health Sciences (Chicago), University of Bridgeport of Naturopathic Medicine(Bridgeport) naturopathic care universities in the nation. Those modalities commonly included in private insurance will be available in the single payer system. The new universal health trust will carefully evaluate including other natural modalities in the new system, following research demonstrating their efficacy. (making this up from whole cloth, someone who knows the answer will need to evaluate it for accuracy) [I do not recommend research demonstrating their efficacy - that is a can of worms - rather if there is a licensing body in Wa state then it is covered, as is true now. So DC, ND, LMTs, LAc, etc]
The earliest we would get a number would be January.