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
4/1/2019

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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