Advocates urge urgent, unified financing as Washington commission studies options

Advocates from a coalition of consumer and health-justice groups told the Universal Healthcare Commission on Sept. 3 that financing a universal system should be urgent, progressive and simple to understand.

At an advocates roundtable opening the commission’s meeting, Nathan Rodke of Washington CAN, Sherry McEvoy of Health Care as a Human Right, and other presenters urged a single, unified financing pool and a range of revenue options — including payroll assessments and progressive contributions — with policies to curb administrative overhead and provider and drug prices. "We need to decouple our health care system from these profiteers," Thomas Kennedy said, recounting personal experience and arguing private insurers and consolidated health interests have driven costs upward.

The Health Care Authority’s director, Ryan Moran, framed the fiscal challenge for the commission, pointing to data showing recent per-person health spending growth near 6.2% and warning that state revenue forecasts leave limited fiscal room for large new expenditures. Moran told the panel the agency will publish 2024 health-cost data in November and that the financing work must balance investment priorities against looming budget constraints.

Advocates proposed a menu of containment tools — global budgets, reference-based pricing, administrative caps and bulk purchasing — and asked FTAC to prioritize a set of guiding principles for a financing design that preserves federal funding and is legally defensible. Several advocates emphasized minimizing or eliminating cost-sharing at point of care; advocates also urged transparent stewardship (a public trust) and clear transition timelines.

Why it matters: Commissioners said the financing recommendations will be central to whether and how Washington can build a universal system. Mary, commission staff, told advocates that FTAC and commission work are targeting an initial financing proposal by mid-2027 and that the commission will consider actuarial analyses once resources permit.

Next steps: FTAC will widen its financing work after completing provider-reimbursement design work, and staff will return to the commission with materials and definition briefings on single- vs. multi-payer options and other foundational choices.

Sources: Remarks to the Universal Healthcare Commission advocates roundtable and presentations by Health Care Authority director Ryan Moran and multiple advocates.