The Honorable Jay Inslee
Governor of the State of Washington

Dear Governor Inslee:

We, the undersigned, thank you for your leadership in protecting and advocating for Washington State and its residents during this global pandemic. We appreciate your early and continuing actions to help our state overcome the public health, economic, and fiscal challenges created by COVID-19. We are writing to you about the current healthcare crisis and to ask for your help in two specific ways, which are outlined in the Requested Executive Actions section below.

The current private/for-profit healthcare system was already in crisis before COVID-19. 522,000 Washington State residents had no healthcare coverage before the pandemic. Now millions more could lose their employer-provided health insurance along with their jobs—as so many already have—in the coming months. These statistics represent real people and genuine hardship that requires urgent action.

I. GAPS/FAILURES IN EXISTING HEALTHCARE COVERAGE SYSTEM EXACERBATED BY COVID-19

A. Healthcare coverage tied to employment

Preceding the pandemic, approximately half of all Washingtonians with healthcare coverage were covered by an employer-provided plan. As a result of the pandemic, this source and model of coverage has crumbled before our eyes. As you know, the Washington Employment Security Department received 109,425 initial claims for the week ending May 9— an 8.6% increase from the previous week—for a total of more than 1 million claims during the pandemic (these dismal figures, of course, have long since surpassed those of the 2008/2009 recession). Accordingly, approximately half of these formerly-employed workers—500,000 people—have now lost their healthcare coverage, many of whom are likely unable to afford the high costs of maintaining between-job coverage under COBRA. This additional half million Washingtonians without healthcare coverage, added to the half million-plus who already were uninsured, means that more than 1 million Washingtonians now lack healthcare coverage. 

B. Unaffordable premiums, deductibles, and co-pays

Washingtonians who still have coverage face the same burden of high premiums, deductibles, and co-pays that pre-existed the pandemic, but they do so now with extremely uncertain economic including the threat of imminent layoffs. One especially outrageous example of these exorbitant costs is the frequent and egregious price gouging that occurs—completely unregulated—around deductibles and co-pays in the prescription drug arena. In addition, premium rates that were already expected to increase by 19% next year are predicted to increase by as much as 40+% due to the effects of the pandemic, according to a March 2020 analysis by Covered California.

C. Pattern of claim payment denial

The current healthcare coverage system is predominantly a for-profit insurance model system, which means that most healthcare coverage carriers focus primarily on keeping their “loss ratios” well below 1.0. In order to do so, these carriers often use almost a default mode of claim denial. The insurance model for healthcare is nearly the worst model imaginable under ordinary circumstances—but it will be devastating during the pandemic, especially with claims for COVID-19 diagnosis and treatment.

D. Fragmented system artificially inflating costs

Not only has the existing healthcare coverage system had a disastrous effect on Washington’s residents, this system also has resulted in out-of-control cost inflation for healthcare providers and facilities due to inefficiencies, “dueling payers,” profit issues and similar problems. Part of the problem with insufficient operational bed capacity, stores of ventilators, PPE, and other equipment is due to these cost issues, which have led to the “just in time” supply and capacity model that most healthcare systems have had to adopt.

II. REQUESTED EXECUTIVE ACTIONS TO ADDRESS THE MOST CRITICAL ISSUES

A. Emergency Powers Proclamation

We request that you issue an order for the duration of the pandemic prohibiting healthcare insurance carriers in Washington from charging any deductible or co-pays for any COVID-19 diagnosis or treatment ordered by an appropriately-licensed healthcare professional. This is beyond the scope of the existing order and subsequent regulations from the Office of the Insurance Commissioner but urgently needed. We also respectfully request that you consider extending this ban on deductibles or co-pays to all healthcare required during this time of extreme economic instability.

B. Emergency Legislative Session

We request that you convene an emergency legislative session, which will allow the legislature to take up matters related to this pandemic crisis, including the above-described healthcare coverage matters.

Many of us have written or plan to write to our state legislators asking them to introduce, support and vote for the following legislative actions in special session:
• Make it impermissible for any Washington healthcare coverage carrier to require its insureds to pay any deductibles or co-pays for the duration of this public health emergency.
• Enact an amended version of SB5222, which was introduced in the 2019/2020 biennium so would still be active. The needed amendments would create a more urgent timeline that would address the issues described in this letter, in order to relieve the existing crisis and to prevent further lasting residual harm from this crisis.

SB 5222 contained all the provisions necessary to implement the Whole Washington Health Trust, which would create the first ever comprehensive universal healthcare system in the United States. In particular, the bill’s Capital Gains Tax provisions (modeled on your own proposed capital gains tax bill) would generate revenues for our state to help provide for the inevitable and likely unprecedented increase in the number of Medicaid-eligible Washingtonians during this crisis period. These provisions alone would capture significant revenue from the wealthiest Washingtonians; this is especially important because other sources of state revenues are struggling.

Healthcare was the number one concern of most voters even before the pandemic, and the Whole Washington Health Trust created by SB5222 will bring every Washington resident quality care, including vision, dental and mental health services. Details are available at www.wholewashington.org, including personal and business savings calculators. Unique strengths of this bill include the following:

1. It’s been reviewed and vetted for procedural feasibility by the Department of Revenue and the Employment Securities Department.
2. It’s backed by a study by Dr. Gerald Friedman, a nationally-renowned healthcare economist.
3. It will save Washington and its residents ~$9 billion annually.
4. It’s fully funded and has a transition phase that doesn’t rely on federal waivers.

Your support for an amended SB5222 as described above would be of tremendous assistance. As the leader of our state in this most serious hour of need, will you help us?

Thank you again for your leadership during this nationwide public health and economic crisis.