NPI's Cascadia Advocate

Offering commentary and analysis from Washington, Oregon, and Idaho, The Cascadia Advocate is the Northwest Progressive Institute's uplifting 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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