Frequently Asked Questions

Universal Healthcare is the only viable solution.

Better Health

• One third of Americans don’t complete doctor’s orders due to cost concerns
• Providers spend too much time doing paperwork related to coverage
• Providers can decide what to do based on what is best for patient, not what will be covered
• People shouldn’t have to worry about money when they're sick

Savings

• No premiums, deductibles or co-pays. Current deductibles are too high and can easily wipe out hard-earned savings.
• Almost all prescriptions are covered with very little out of pocket cost. There will be a small co-pay with an annual per-person maximum of $250 per year (when brand name drugs are used instead of generics for non-preventative conditions).
• Costs should be predictable, controlled, and the same for everyone. The cost of current plans may vary based on age or medical condition of recipient, or overall health of other people enrolled in plan.
• 90-95% of Washington residents are expected to pay less

Social Justice & the Greater Good

• Racism is a public health crisis. Universal healthcare is a required first step
• Healthcare is a human right. Profit doesn’t belong in healthcare
• Medical debt is the number one cause of bankruptcy and homelessness
• Residents of WA counties with poor access to healthcare have shorter life expectancy
• Crowdfunding healthcare is immoral
• Inadequate access to mental health and addiction services is a public safety issue
• Almost every other comparable country uses this system and has better health outcomes that cost less
• People end up in hospitals or die from conditions that could have been controlled without hospitalization

Individual Freedom

• Your ability to be healthy should not depend on what kind of job you have
• People shouldn't stay in jobs they would otherwise leave to secure healthcare coverage
• People shouldn't stay in relationships to maintain access to healthcare
• Artists and innovators shouldn’t be held back by fear of losing benefits

Fiscal Sustainability

• The Washington Health Trust will save billions each year
• Employers and people spend too much time trying to figure out which plan to buy
• Rising costs make it difficult for businesses to compete. The Employer Contribution is predictable
• Insurance and financial processing jobs lost will be replaced by jobs created in the healthcare sector when more patients seek the care they need

Yes! Economic analyses show significant savings in the billions when Washington State adopts a Universal Healthcare model. Economist Dr. Gerald Friedman did two separate studies, both showing significant savings:

In his 2018 study, the projected cost of the current system for 2019 was nearly $80 billion on healthcare. The universal public health trust covering all essential health benefits would cost less than $70 billion, a savings of more than $9 BILLION. That's even accounting for covering all state residents coverage with expanded and improved benefits.

In his 2021 revised study, showed a savings of 12.7 billion.

These savings come from the ability to negotiate drug prices and the reduction of administrative waste. To get more in-depth, see the Studies page.

No - employer-sponsored plans, including union-negotiated Taft-Hartley plans, are currently protected under federal law (ERISA) and would continue to be an option for employers in Washington. Individuals will also still be able to purchase private insurance plans as a supplement or alternative to the coverage offered by the state plan.

While we cannot guarantee that the health insurance industry and employers will continue to offer the plans they offer today, the reality is that private insurers frequently reduce coverage while charging more under the current system and there is never a guarantee that you can maintain your benefits under the private insurance system.

Yes! The initiative creates a “DISPLACED WORKER TRAINING ACCOUNT” which can only be used for retraining and job placement of workers displaced by the transition to the trust.

Single payer is a type of universal healthcare system in which all medical providers (whether public or private) bill the government for all health services, hence making the government the "single payer" of healthcare costs. It can be thought of as a public insurance system that covers everybody and publicly finances all care without charging a deductible, copayment, or medical bill. Similar to a public school, library, or fire department - it makes the healthcare system free to use.

Single payer is considerably more simple and cost-efficient than our current system because it eliminates the administrative complexity of working with dozens of insurance companies and plans all of which cover different populations and reimburse different amounts for the same service. Instead you have everyone covered under the same plan and reimbursement rates are uniform and consistent.

The Washington Health Trust (WHT) is perhaps best understood as a state-level transition framework to single payer. The bill instructs the state to seek federal waivers to fully integrate federal programs (and dollars) including Medicare, Medicaid, and the Affordable Care Act. However, the Veteran Affairs and Indian Health Services will remain as separate programs that the WHT supplements. Employer-sponsored plans, including union-negotiated Taft-Hartley plans, are currently protected under federal law (ERISA) and would continue to be an option for employers in Washington. Individuals will also still be able to purchase private insurance plans as an alternative or supplement to the coverage offered by the state plan.

However, for the majority of Washingtonians the WHT would become the "default" form of health coverage. Children could be enrolled at birth and stable coverage could be maintained across childhood, education/career, and retirement. It would be an individual choice to opt-out in favor of a private option.

Universal healthcare is 100% achievable for Washington, with or without federal support. We believe in health care for all including those who do not live in Washington so we also support federal legislation like Medicare for All and the State Based Universal Health Care Act.

The Washington Health Trust is designed to take advantage of all available federal dollars via Medicare, Medicaid, and the Affordable Care Act and raise all additionally needed funds via in-state dollars, but the reality is that Washington's economy is more than large enough to fully fund healthcare from state dollars alone, if the state is willing to collect them.

Federal support and funding of course would help Washington more quickly achieve a well funded and administratively simple universal healthcare system - the bill legally instructs the state to obtain all waivers to fully integrate federal funds into the trust. While this achievement will improve efficiency in administration, it’s not necessary to establish the program or remain solvent.

I-1471 creates new taxes and a universal healthcare system. There's a rational connection between the component parts of a law, which serve a related purpose. The revenue components are tied directly to implementing the universal healthcare plan.

See Lee v. State, 185 Wn.2d 608, 374 P.3d 147 (2016).

If you have Medicare, you will have the option to enroll in the Washington Health Trust as your supplemental Medigap plan at no additional cost. If you’re happy with Medicare, you can continue as is and use any supplemental Medigap plan  available to you.

Having the Washington Health Trust as your Medigap plan gives you these benefits.

• You'll receive expanded benefits, like vision, dental, audiology, and prescription drug coverage.
  • Most prescriptions are fully covered, including all generics. The most you’ll pay for prescriptions that aren’t covered is $250/per person, per year for brand name prescriptions who have a generic equivalent.
• You'll eliminate out-of-pocket costs like co-pays, deductibles and coinsurance.
• You'll be able to see the provider of your choice.

As part of the long term transition, the plan would be to transition all Medicare enrollees into the Trust as a Medicare Part C plan. We don’t know if or when that will be available as it is dependent on the actions of the federal government. As a Medicare part C plan member you would receive all the benefits of the trust. The benefits to the trust is that it would help to streamline administration expenses.

Yes! ​Qualified out-of-state providers can negotiate for reimbursements, but providers are not required to accept reimbursement from the new trust. Enrolled residents who are temporarily out-of-state will be covered to see out-of-state providers for emergency services because of current state and federal laws regulating essential health insurance coverage, but the new public trust has the authority to include out-of-state providers beyond emergency services.

Yes! All residents can enroll, regardless of employment.

Absolutely! All children under the age of 19 are covered with no out-of-pocket costs.

Yes! Dental, vision, and more are considered essential and will be covered.

No. There will be no co-pays.

1. Hospice and end of life care.
2. Long term care benefits at least at the standards of Medicaid coverage

Sometimes. There will be a prescription drug schedule to incentivize generic use, but which can’t limit effective care or be applied to preventative medicine. The copays only apply to adults earning over 200% FPL and can’t exceed $250 annually.

Yes.

No. You and your doctor decide what medical care is right for you. The WHT just pays the bill.

1. Hospice and end of life care.
2. Long term care benefits at least at the standards of Medicaid coverage

Yes! The public health trust created by the Washington Health Trust will negotiate rates with all qualified providers who wish to participate for reimbursement. The trust is obligated to negotiate global budgets with non-profit community health providers in each Washington state county, but all qualified providers will be able to collectively negotiate traditional fee-for-service reimbursements. Providers will not be required to accept the reimbursements negotiated by the trust.

Yes! The Washington Health Trust creates no networks and all licensed providers are eligible to participate and receive reimbursement from the Trust. Participating providers will be included in a collective bargaining agreement with the state regarding reimbursement rates. Ultimately each provider will decide if they participate.

Yes! While providers cannot currently negotiate with Medicare and Medicaid, under the Washington Health Trust, participating providers will engage in a collective bargaining agreement with the Governance Board to determine reimbursement rates. Additionally, provider costs will decrease due to a significant reduction in administration.

The reason reimbursement rates are not currently specified is because prior to the formation of the governance board that negotiation can't happen. Setting reimbursement rates in law would not be sustainable because then they could not be adjusted without a full vote of the legislature and Governor's signature which is why they are an administrative decision instead of a statutory one.