Washington

July 2025
Marcia Stedman, Communications Co-chair and Cris Currie, Policy Committee Member, Healthcare for All Washington; and Jen Nye, Whole Washington Communications

State-based SP organizations (state, national)

State-based bills

Senate Bill 5233  - Developing the Washington Health Trust
Introduced with a record 11 co-sponsors: Hasegawa, Bateman, Chapman, Dhingra, Liias, Lovelett, Nobles, Saldaña, Shewmake, Stanford, Trudeau)

House Bill 1445  - Developing the Washington Health Trust
House companion bill introduced with a great first time showing of 17 co-sponsors: Parshley, Scott, Berry, Doglio, Farivar, Alvarado, Reed, Ramel, Wylie, Goodman, Cortes, Macri, Fosse, Ormsby, Pollet, Hill, Simmons)

The Washington Health Trust (WHT) allows any Washington State resident or business to enroll in a publicly funded, not-for-profit, healthcare plan. Coverage includes medical, dental, vision, reproductive care, mental health services, gender-affirming care, and more. Services would be free at the point of service with no out-of-pocket expenses or medical bills. The legislation includes dedicated funding mechanisms, a transition plan, and a governance structure. 

The bill did not advance out of either of the healthcare committees before the end of the 2025 legislative session.  Fifteen Washington State healthcare advocacy organizations sent a request to the Chairs of the Senate and House healthcare committees asking for an urgent joint working session to review the Washington Health Trust in the interim before the start of the 2026 session. 

In addition, the Washington Health Trust is to be considered by the permanent Universal Health Care Commission as time and resources allow.

2025 Legislation preparing Washington for a universal health care system

WA 2023-2025 biennial budget includes funding for 2 important priorities:

  • $514,00 for the Universal Health Care Commission (UHCC)

  • $1.0 million to create an autoenrollment program for those transitioning between Medicaid and the Health Benefit Exchange

SJM 8004 – Requesting that the federal government create a national universal health care program in one of three ways: either create a national universal health care program, pass California Rep. Ro Khanna’s State Based Universal Health Care Act HR 4406 (2025), or grant the Federal waivers that Washington needs to fully implement our own publicly funded universal health care system. It passed the legislature and was sent to the President and Congress as the first state resolution of its kind!

SB 5493  requires more transparency in hospital pricing.

HB 1686 will begin the process of creating a registry to clarify healthcare entity ownership.

SB 5122 enacts a uniform pre-merger notification process.

SB 5084 requires carriers to report primary care expenditures.

SB 5480 prohibits the use of medical debt in credit scores.

HB 1392 creates a fund to increase reimbursement rates for Medicaid providers.

SB 5083 requires that reimbursements for health care services provided to state employees be pegged to Medicare rates (reference-based pricing).

HB 1186 allows hospitals to provide more than a three-day prescription for certain drugs at discharge.

Obstacles to SP in the current context

  • Lack of direction in the original UHCC legislation to drive the vision towards single payer.

  • Loss of additional funding for the Universal Health Care Commission due to Federal cuts to Medicaid and Affordable Care Act support and Washington’s $9billion budget shortfall

Advantages for SP in the current context

  • The current severe budgetary constraints make the need for serious health care reform more urgent and immediate than ever.

  • The Universal Health Care Commission (UHCC) and its Finance Technical Advisory Committee (FTAC) meetings are open to the public, with opportunities for public comment during the meetings and in writing, and presentations from single-payer advocates in other states such as Oregon.

  • New leadership at the Health Care Authority is more receptive to the public comments from UHC advocates, and has scheduled an informal discussion with advocates and Commission and FTAC members for August 5, 2025.

  • One-third of the UHCC members were nominated by universal health care advocacy organizations and are single-payer supporters.

  • One FTAC member is a strong single-payer supporter with deep knowledge and experience in the state’s Medicaid program, and an active member of HCFA-WA’s Policy Committee.

  • The state’s single-payer and health justice groups are bonded in a strong coalition, Health Care is a Human Right, that meets regularly to strategize together, debrief Commission meetings, organize public testimony, and publish e-bulletins to share with their members.

  • Washington single-payer advocates regularly participate in One Payer States activities and planning meetings.

 Goals for SP movement in WA 2025-26

  • Continue our active involvement with the UHCC and FTAC, urging them to consider the revised Washington Health Security Trust (or SB5233) as a template for their recommended plan and propose other ways to hasten progress.

  • Continue working in coalition with other state single-payer advocates and groups.

  • Expand outreach to Democratic legislative districts and labor groups.

  • Push the WA Congressional delegation to co-sponsor HR 4406/ S 4817, CA Rep. Ro Khanna and MA Sen. Ed Markey’s State Based Universal Health Care Act of 2025

  • Push back against the privatization of Medicare

Where can people find news about Single Payer in your state and/or join a group?*

Health Care for All-Washington https://www.hcfawa.org/

Whole Washington  www.wholewashington.org

Health Care is a Human Right Washington Campaign  http://www.healthcareisarightwa.org/

PNHP Western Washington  https://www.pnhpwashington.org/

For the full state report, including historical context, please see our Washington archive.