State agency budget decision packages were posted to the Office of Financial Management website last week. As expected, they appear to include most – if not all – of the cuts identified in the savings options exercise that agencies undertook this spring at the direction of the Governor in light of significant expected revenue shortfalls. 

 The scope of the proposed cuts is breathtaking and alarming.  The Health Care Authority, for example, submitted decision packages that would:

• Eliminate programs providing health coverage to low-income non-citizen children, non-citizen adults, women diagnosed with breast or cervical cancer, individuals with end stage renal disease, and COFA islanders
• Eliminate a host of critical services, including adult dental services, physical therapy, maternity support services, occupational therapy, case management for infants hospice, and abortions 
• Drastically reduce Medicaid-funded interpreter services
• Eliminate school-based healthcare services programs
• Reduce funding for behavioral health services

The potential impact on low-income Washingtonians is staggering.  While we are still analyzing the decision packages, more than 93,000 low-income Washingtonians would be impacted by the cuts to occupational, physical, and speech therapies, approximately 96,000 would be impacted by the cut to interpreter services, and almost 1,000,000 people would be impacted by the cut to adult dental services. 

Access to health care services is critical now more than ever, with the pandemic and recession laying bare existing health and racial inequities. But these proposed cuts would undo much progress incrementally achieved over the past decades – specifically, progress that has made coverage and care more equitable, and services more accessible, to immigrants and people of color.  The proposed cut to the non-citizen children’s health program, for example, would eliminate coverage for more than 19,000 immigrant children in our state.  NoHLA and other organizations have urged the Legislature that this is a critical time to preserve and strengthen our state’s safety net, rather than cut these services. 

Legislative committee agendas for September and October have been released.  Meetings will be held virtually and will be broadcast on TVW.  Agendas and materials are available on the Legislature’s website. Even if you can’t make a hearing, it will be archived on TVW for you to watch at your convenience. It’s particularly important for all of us to watch closely how our state government chooses to respond in these critical times.  

Upcoming meetings of interest 

Senate Behavioral Health Subcommittee to Health & Long-Term Care, Sept. 22 at 1 p.m.:

• Expanding roles for certified peer counselors in acute care settings.
• Certification of behavioral technicians by the Department of Health.

Behavioral Health Recovery System Transformation Task Force, Sept. 25 at 1 p.m.:

• Behavioral Health community capacity updates.
• Foundational community supports.
• Committee discussion.

Senate Special Committee on Economic Recovery, Sept. 29 at 10 a.m.: 

• Economic impact of 2020 forest fires.
• Overview from Employment Security Department on Washington’s current labor market.
• Main street Washingtonians perspective on the pandemic and their experiences with health care and childcare.
• Small Business Challenges.
  o   Hospitality and service sector.
  o   Childcare.

House Health Care & Wellness, Oct. 5 at 3 p.m.: 

• COVID-19 outbreak and response.
• Rural health care system.

Senate Ways & Means, Oct. 13 at 10 a.m.:

• Update on forecasted revenues.
• Update on forecasted caseloads.
• Update on collective bargaining agreement.
• Update on Public Employee and School Employee benefit rates.
• Update on unemployment trust fund.

Joint Legislative Executive Committee on Planning for Aging and Disability Issues, Oct. 14 at 3 p.m.: 

• COVID-19’s impacts on individuals with development disabilities.
• Department of Social and Health Services budget update.
• Public comment. (Remote testimony available.)

Joint Select Committee on Health Care Oversight, Oct. 26 at 1 p.m.: 

• The COVID-19 outbreak and response.
• The use of telehealth during the COVID-19 outbreak and response.
• The impact of COVID-19 on the rate of uninsured individuals.

We encourage you to keep an eye on these hearings and communicate with your legislators about your interests and concerns regarding maintaining and improving health care access.

– Alexa Silver, NoHLA Consulting Attorney