NPI's Cascadia Advocate

Offering commentary and analysis from Washington, Oregon, and Idaho, The Cascadia Advocate is the Northwest Progressive Institute's unconventional perspective on world, national, and local politics.

Friday, April 5th, 2019

Bill to enshrine Patient Protection Act provisions into state law heads to Inslee

Washingtonians worried about Donald Trump’s efforts to destroy the Patient Protection Act can take comfort in knowing that their state government has taken action to protect the health freedoms they gained during the Obama years.

Substitute House Bill 1870 headed to Governor Jay Inslee’s desk this week after being amended to include an emergency clause. The change to the bill’s effective date was prompted by the Trump regime’s renewed efforts to get the Patient Protection Act struck down as unconstitutional.

The inclusion of the emergency clause means the bill will take effect upon its signing by Inslee. Healthcare policies sold in Washington would be immediately required to honor existing protections in the Patient Protection Act even if those standards are eliminated by action taken at the federal level.

“We know the Trump administration has vowed repeatedly to repeal the [Patient Protection Act], and last week’s actions prompted us to get these protections into law as quickly as possible,” said Sen. Annette Cleveland (D-Vancouver), who sponsored the amendment to add the emergency clause.

“We’re just a signature away from protecting Washingtonians from losing the health care they need, regardless of what the White House or the courts do.”

Following the December 14, 2018 ruling by a Texas federal judge that ruled the Patient Protection Act’s individual mandate unconstitutional, attorneys general from sixteen states, as well as the District of Columbia, filed an expedited motion seeking to clarify the law’s status. The New Orleans 5th Circuit Court of Appeals last week has cast even further uncertainty over the future of the PPA.

Many political observers believe healthcare was the issue that most dominated the 2018 midterm elections and contributed to the Democratic Party’s takeover of the House of Representatives. The party made defending the Patient Protection Act its main campaign theme in districts throughout the country.

“With [Donald] Trump trying to use the courts to take health insurance away from 20 million Americans, it’s imperative that elected leaders in our state take action to protect access to lifesaving and life-giving health care,” said prime sponsor Representative Lauren Davis, D-32nd District. Davis is a freshman lawmaker and HB 1870 was her first bill to pass both chambers of the Legislature.

“Families across our state rely on these services, and the prospect that their access to health care could disappear tomorrow is terrifying,” said Davis.

“Washington can ensure patients can receive healthcare coverage regardless of a preexisting condition, that lifetime cap limits remain, and that essential health benefits remain available in healthcare plans. I am proud to put people first and prioritize healthcare for all.”

Key provisions in the Patient Protection Act that SHB 1870 requires healthcare plans sold in Washington state will be required to uphold include:

  • Strict annual limits on out-of-pocket costs, such as copays and deductibles;
  • Prohibition against denying coverage based on existing medical conditions;
  • Guarantees that patients can’t be dropped except in cases of fraud;
  • Stopping patients from being charged more based on their health status;
  • Barring providers from capping the maximum cost of coverage or benefits in a patient’s lifetime; and
  • Providing patients with a standardized summary of benefits so they can more clearly understand what is covered.

The bill also codifies requirements for outpatient care; emergency services; hospitalization; pregnancy, maternity and newborn care; mental health and substance abuse treatment; prescription drugs; rehabilitative services and equipment; laboratory services; preventive and wellness services and chronic disease management; reproductive care; breastfeeding; and pediatric services.

After it was sent back to the House for approval of the Senate’s amendment, SHB 1870 passed with fifty-six yeas and thirty-seven nays.

The roll call in the House was as follows:

Roll Call
HB 1870
Affordable Care Act protections
Final Passage as Amended by the Senate

Yeas: 56; Nays: 37; Excused: 5

Voting Yea: Representatives Appleton, Bergquist, Blake, Callan, Chapman, Cody, Davis, Doglio, Dolan, Entenman, Fey, Fitzgibbon, Frame, Goodman, Gregerson, Hansen, Hudgins, Jinkins, Kilduff, Kirby, Kloba, Leavitt, Lekanoff, Lovick, Macri, Mead, Morgan, Morris, Ormsby, Ortiz-Self, Orwall, Paul, Pellicciotti, Pettigrew, Pollet, Ramos, Reeves, Riccelli, Robinson, Ryu, Santos, Sells, Senn, Shewmake, Slatter, Springer, Stanford, Stonier, Sullivan, Tarleton, Thai, Tharinger, Valdez, Walen, Wylie, Chopp

Voting Nay: Representatives Barkis, Boehnke, Caldier, Chambers, Chandler, Corry, Dent, Dufault, Dye, Eslick, Gildon, Goehner, Graham, Griffey, Harris, Hoff, Irwin, Jenkin, Klippert, Kraft, Kretz, MacEwen, McCaslin, Mosbrucker, Orcutt, Rude, Schmick, Shea, Smith, Steele, Stokesbary, Sutherland, Van Werven, Walsh, Wilcox, Ybarra, Young

Excused: Representatives DeBolt, Maycumber, Peterson, Vick, Volz

Governor Inslee has promised to sign the bill quickly.

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