Virtual Conversation | Recapping the 2021 Session: Legislative Republicans, May 18, 2021 Register

How health equity showed up in the legislature this session

The past year has shined a spotlight on the systemic inequities that proliferate the nation. In Washington, a theme of the session seemed to be addressing these inequities, specifically through reforms to health policy.

Some of the bills that managed to pass the packed session include:

SB 5068

This bill, sponsored by Sen. Emily Randall, requires the Health Care Authority (HCA) to provide one-year of postpartum coverage through Apple Health. This coverage would be provided to Washington residents who have an income at or below 193% of the federal poverty level. If an enrollee’s income changes in this time, they will not lose coverage. 

Randall said this bill is an important way to address systemic inequities, especially those that were exacerbated by the pandemic.

This is so important now, in this moment to enact this policy. We know that there are disproportionate health outcomes for particularly moms of color. We also know that two months is hardly enough time to get yourself cared for after giving birth to a new baby and trying to get all of its many visits done. And we also know because of the extension of the FMAP increase under the federal policy, we have been extending coverage and ensuring that new birth parents are covered for longer. And what I don’t want to do at the end of the emergency is to create a huge cliff and all of a sudden kick everyone off.”

This bill has been signed by the Governor.

SB 5228

This bill, also sponsored by Randall, requires each public medical school in the state to develop a health equity curriculum for medical students by Jan. 1, 2023. The objective of this curriculum is to provide tools for eliminating structural racism in health care systems and build cultural safety. In a House Health and Social Services committee hearing on the bill Randall said: 

I have watched some members of our community die from the coronavirus and others get the care that they needed. I had a personal experience, one of my college classmates, a black woman who tried to get treatment for COVID-19 and was unsuccessful advocating for herself because her doctors told her it was probably asthma, or she was probably overweight and she probably didn’t need as much care as she was asking for. And she died last spring at the age of 30.”

This bill has been signed by the Governor. 

SB 5229

This bill, sponsored by Randall, will require health care professions that are subject to continuing education requirements to adopt rules requiring licensees to complete health equity continuing education training at least once every four years. This must begin by Jan. 1, 2024.

This bill is on the Governor’s desk awaiting his signature.

SB 5141

This bill, sponsored by Sen. Rebecca Saldaña, will establish environmental justice plan implementation, equitable community engagement and public participation, tribal consultation, assessment and budget and funding obligation requirements for various departments, including the Department of Health (DOH).

The bill will also establish the Environmental Justice Council to adopt guidelines in coordination with an interagency workgroup to be considered by agencies.  The council will also evaluate the progress of agencies implementing environmental justice requirements, recommend the identification and prioritization of actions for assessments and provide a forum for the public to testify on concerns.

Saldaña said agencies and policymakers have known the health issues that environmental justice disparities lead to for a long time and now is the time to act to change those outcomes.

We’ve done a lot of studies, as I look back Senator Rosa Franklin had an environmental justice study ten-plus years ago. Ten years before that there was another one, we do a lot of studying but we don’t do a lot to change our policy. So that is what I am hoping this bill will do. Because we know what the problems are.”

This bill is on the Governor’s desk awaiting his signature.

SB 5377

This bill, sponsored by Sen. David Frockt, will establish a state premium assistance and cost-sharing reduction program for qualified health plans that are purchased through the Washington Health Benefit Exchange. It will also establish requirements on the number of standardized plans offered through the Exchange. The bill will also establish participation requirements for certain hospital systems regarding state-procured qualified health plans offered through the Exchange starting in 2022.

Frockt said getting hospital involvement in the original Cascade Care bill has been hard.

But a major problem that they had in the course of this contracting environment, because we didn’t have enough carrots and sticks in the bill [Cascade care bill], was that several of the major hospital systems and some of the biggest ones in the state simply refused to participate. And we’ve got to have this market which is so vital to 200,000 people … They have to have options to look at these plans in every corner of the state and we don’t have that.”

This bill is on the Governor’s desk awaiting his signature.

SB 5313

This bill, sponsored by Sen. Marko Liias, will require the HCA, managed care plans and providers that administer gender-affirming services through Medicaid programs may not discriminate in the delivery of a service based on a person’s gender identity or expression. The HCA and Medicaid are also prohibited from applying categorical cosmetic or blanket exclusions to gender-affirming treatment. 

Liias said this bill is a commitment to protecting trans people in Washington.

I’m absolutely disgusted by what I’m reading in the headlines right now about these anti-trans bills being proposed in other states. What we’re seeing right now out of Arkansas, Florida, and other states is truly appalling. I’m extremely proud of Washington’s commitment to protecting our trans family members, friends, neighbors, and co-workers by passing bills like the Gender Affirming Treatment Act. Trans families are welcomed and supported here in Washington state.”

This bill is on the Governor’s desk awaiting his signature.

SB 5052

This bill, sponsored by Sen. Karen Keiser, will require the DOH to review relevant health and population data to identify, or allow communities to self-identify, potential health equity zones in the state and develop projects to meet the unique needs of each zone. The DOH must use the first 12 months to develop a plan and process to allow communities to implement health equity zone programs statewide and may determine the number of zones and projects based on available resources.

This bill is on the Governor’s desk awaiting his signature.

These bills are just some of the ways equity showed up in the legislature this year, but they represent a step towards addressing the systemic inequities that have existed in Washington for years.

This story was cross-posted on our sister site State of Reform.

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