Policy Opportunities and Achievements in the 2024 Session

In 2025, we face new threats to health care from federal instability, as well as a serious state budget shortfall. But NoHLA won’t back down from our commitment to health justice. We are fighting cuts to the health safety net and pushing state and federal policymakers to affirm equitable care. Our priorities include:

Equity

Protect Washington’s commitment to equitable care, including bolstering Washington's new immigrant coverage programs and supporting a full range of reproductive care.

Access

Defend Medicaid, Medicare, and the Affordable Care Act from federal attacks. Address access challenges for Washingtonians who rely on public coverage programs.

Affordability

Together with partners in our Fair Health Prices Washington campaign, lower health care prices and safeguard Washingtonians from medical debt and profit-driven corporate health care.

Equity: Expand capacity for Washington’s new immigrant coverage programs.

NoHLA played a key role in securing a historic victory last session: a commitment to make health coverage available to all Washingtonians, regardless of immigration status. As a result of this advocacy, Washington is launching new coverage options for immigrants in 2024. But the funds allocated to these programs fall far short of the need. Community groups across the state are asking the state to meet the need with funds to:

  • Apple Health capacity.  Expand capacity for the new Apple Health program for undocumented adults.
  • Community engagement. Provide additional support for community members to engage with the agencies and ensure public accountability.
  • Fair systems. Establish fair waitlist systems until programs are fully funded.
  • Future needs. Direct the Health Care Authority and Health Benefit Exchange to study the cost of remaining capacity and affordability gaps.

Learn more in our 2024 Legislative Wrap-Up.

Access: Improve access to care, addressing benefit and cost gaps for Washingtonians who rely on Medicare, Medicaid, and Exchange coverage.

Thanks to years of advocacy from NoHLA and allies, most Washingtonians now have health coverage. Unfortunately, many still can’t access care due to missing benefits, high out-of-pocket costs, and bureaucratic hurdles.  We supported proposals to the legislature to address these access challenges, including:

  • Medicare Affordability Cliff study.  Funds for a study of the cost of additional state policy options that can lay the groundwork to remove the asset test, expand eligibility for Medicare Savings Programs, and enable future improvements to address the Medicare Affordability Cliff.
  • Continuous Apple Health for Kids. Increased budget funding will extend Children’s Health Insurance Program coverage continuously from birth to age 6, regardless of changes in household circumstances, to strengthen early childhood health.
  • Apple Health maternity/postpartum expansion. Eligibility for pregnancy/postpartum coverage was increased to a higher income limit and expanded supportive maternity services to improve maternal health outcomes.

Preventive services. We now have protections in Washington state law that codified the Affordable Care Act’s preventive services requirements, so that federal attacks can’t harm Washingtonians who rely on preventive care such as contraception and HIV prophylaxis.

Affordability: Address the drivers of rising health care prices with proven solutions.

NoHLA is a founding leader of Fair Health Prices WA, a statewide movement to address the root causes of the health care affordability crisis that is pricing Washington families and businesses out of health care. In the 2023 session, we won legislative direction for a joint study by the Insurance Commission and Attorney General of the big business of health care that is changing our health care landscape. These reports, released before the start of the 2024 session, helped lawmakers better understand the complexity of Washington’s health care market. In 2024, we advocated and won on two priorities to address high health care prices:

  • Health spending benchmark. We were successful in our effort to increase spending transparency and accountability with  the Health Care Cost Transparency Board by adding consumer, labor, and employer purchaser representatives to the board, requiring insurers and providers that exceed health care cost goals to participate in a public hearing, and gaining a better understanding of the underinsurance problem (HB 1508).
  • Unreasonable ground ambulance billing. We gained protections on unreasonable ground ambulance balance billing practices and now the amount that can be charged by ground ambulance services will be limited (SB 5986).

We were also looking for opportunities to expand Exchange affordability. NoHLA has been a leader in state efforts to improve the Exchange plans available to individuals and families through Washington Healthplanfinder. We and our allies were at the helm for ground-breaking efforts like the nation’s first public option and first 1332 waiver to open the Exchange to all Washingtonians. These efforts are working to improve affordability, but it’s time for the state to consider the next wave of Exchange reforms, supported by recent Exchange reports. This session, we secured a study to better understand affordability gaps and their impact, such as high out-of-pocket cost-sharing for immigrants and others.

For more information on the legislative session, check out our blog.