FAQs about I-1600

Will this new system save Washington State residents money?

Yes! 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 trust covering all essential health benefits will cost less than $70 billion, a savings of more than $9 BILLION in healthcare costs for Washington state residents, even accounting for costs related to expanding and improving coverage. The public health trust saves on every aspect of public and private funded healthcare administration, resulting in more than $9 Billion in savings on the cost of the current care being provided. As a result, the public health trust has more money to fund healthcare access. Providers can expect to spend 10% less time on administration, and we can all spend less on drug prices and fraud.

Will I be covered if I get medical treatment outside the state?

Yes! Qualified out-of-state providers can negotiate for reimbursements. Enrolled residents who are temporarily out-of-state will be covered to see those out-of-state providers.

Will vision & dental be covered?

Yes! Dental & vision will be covered.

Will I be covered even if I am unemployed?

Yes! All adults residents earning under 200% FPL (Federal Poverty Level) will be eligible to enroll with no premium, regardless of employment.

Will I be covered even if I am unemployed?

Yes! All adults residents earning under 200% FPL (Federal Poverty Level) will be eligible to enroll with no premium, regardless of employment.

Why did Whole Washington pay for an economic analysis?

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.

Will current Medicare and most other federal program enrollees be eligible?

Yes! Pending approval of a federal waiver to integrate Medicare, Medicare premiums will be reimbursed by The Whole Washington Healthcare Trust to Medicare recipients who enroll in the trust for expanded coverage. Medicare enrollees with incomes over 200% FPL will owe the premium established by the trust until federal waiver is granted integrating Medicare in Washington.

The board is instructed to reduce the premium owed by higher earning adults (including Medicare recipients) to the fullest extent possible, so improved administrative savings achieved result in a lower and lower premium over time even if the federal waiver is not granted to integrate Medicare directly. There are also temporary costs that we've accounted for like a "Displaced Worker" program and temporary waivers for businesses. Over time these costs will be reduced and the savings will also result in further reducing the premium (ideally to zero).

For more details, see the Medicare page.

Will I have to pay co-pays when I go to the doctor?

No. There will be no co-pays.

Will children be covered?

Yes! All Children under the age of 19 are covered with no premiums or out-of-pocket costs.

Will doctors and hospitals sign up for payment through the Whole Washington Health Trust?

Yes! The public health trust created by this initiative will negotiate rates with providers who wish to participate for reimbursement. The trust is obligated to negotiate global budgets with non-profit community health providers in each Washington County, but all qualified providers will be able to collectively negotiate traditional fee-for-service reimbursements.

I have private insurance now. How will my employer-based health care be affected?

Employers are averaging 12% of payroll for employee coverage currently. During transition, employers who offer ACA compliant coverage to employees may opt out of the health security assessment for those employees. Our proposed health security assessment of 8.5% with an exemption on up to $12,000 in pay per employee each year means the average employer will pay under 7% of payroll on average to participate. This will be an appealing option and many employers will simply be relieved to have a less expensive (and potentially free) option to provide coverage. Employees will be able to opt in during the transition and decline their employer coverage by paying the health security assessment on their pay themselves. Once 51% of residents in the state are enrolled in a state-administered health insurance and employers will no longer be able to opt out. Employers may pay premiums employees and their spouses premiums (if they owe them) and may continue to offer supplemental coverage.

Our Initiative doesn't restrict employers from offering additional insurance coverage or any residents from purchasing additional insurance coverage.

Will this cover hospice or long term care?

Some. The coverage will include limited long term care benefits:

  1. Hospice and end of life care.
  2. Long term care benefits and eligibility at least as generous as Medicaid coverage as it exists now.
  3. "Subject to ongoing and consistent funding..." our plan proposes including long term care benefits beyond this after January 1, 2022.

Also, our proposal doesn't interfere with any benefits related L&I, Veterans benefits, or Indian Health Services or their funding. We do expect these federal programs to experience reduced spending for all essential health benefits provided to residents covered by the plan.

My current insurance covers acupuncture, 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.
Will I have to pay co-pays for prescription drugs?

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.

If I just moved to Washington State, how long until I am covered?

Not long! Residence status for healthcare is defined by Medicaid in Washington: https://www.hca.wa.gov/free-or-low-cost-health-care/program-administration/residency.

Immediately, if employed, or an employer moves an employee to Washington.

Will the initiative address the outrageous cost of pharmaceuticals?

Yes! The public health trust will negotiate the lowest possible prices with pharmaceutical companies for Washington residents using all available methods including bulk purchasing with Washington’s Tribes.

Does this initiative cover more than one issue at a time?
According to state ballot measure law, ballot measures can only address one issue at a time. I-1600 creates new taxes and a universal healthcare system. Will this be an issue for passing the measure?

No. As long as there is a rational connection between the component parts of a law which serve a related purpose, the initiative will satisfy the Constitution. The revenue components of I-1600 are tied directly to implementing the universal healthcare plan.  See Lee v. State, 185 Wn.2d 608, 374 P.3d 147 (2016).

Will I-1600 help workers who are displaced because of this legislation?

Yes! Sec. 123 on page 25 creates a “DISPLACED WORKER TRAINING ACCOUNT” which states: “The displaced worker training account is created in the custody of the state treasurer. Expenditures from the account may be used only for retraining and job placement of workers displaced by the transition to the trust.“

Is an income tax constitutional?

Yes, the I-1600 income tax is constitutional. The Initiative imposes a 1% tax on adjusted gross income and exempts the first $15,000 from that tax. This complies with Washington State Constitution Art. 7, Sec. 1’s requirement that an income tax “be uniform” while permitting the exemption “of fifteen thousand ($15,000.00) dollars for each head of a family.”

I-1600’s income tax also complies with Washington State Constitution Art. 7, Sec. 2’s limitation of an annual tax of not more than “one percent of the true and fair value” of the income.

Would the Whole Washington Trust cover reproductive services like abortions?


If I'm Self-Employed with no Employees, do I pay the Payroll Tax?

No. The 8.5% Payroll tax would not apply.