Blog

The impact of federal Medicaid changes on the state budget is uncertain

Recent federal legislation made changes to Medicaid, which has led to concerns about the impacts to insured populations and the state budget. Medicaid is an optional program that is funded by the state and the federal government. Some populations and benefits are mandatory, and states may add other populations and benefits with federal approval. For […]

Dept. of Health wants to maintain pandemic-era funding levels in 2025–27

The Department of Health (DOH) has requested $459.3 million from the general fund–state (GFS) for 2025–27, which would be an increase of 22.5% over 2023–25. DOH funding increased substantially in 2021–23 due to pandemic-related programs and enhanced funding for foundational public health. Appropriations decreased in 2023–25, but they are still 76.9% higher than 2019–21 spending […]

Health Care Authority requests an 8.9% budget increase (not including caseload forecast impacts)

The Health Care Authority (HCA) is requesting $8.847 billion from the general fund–state (GFS) for 2025–27. That is an increase of $724.6 million (8.9%) over enacted 2023–25 appropriations. Of the increase, $90.9 million is carry-forward, $180.6 million is maintenance, and $477.0 million is new policy. (See the box at the bottom of this post for […]

State Supreme Court avoids involvement in problem of competency evaluation delays

Today the state Supreme Court dismissed a request from the Spokane County prosecutor that the Court issue a writ of mandamus directing the Secretary of the Department of Social and Health Services (DSHS) to “timely provide competency services in criminal proceedings.” According to the Court, the DSHS secretary is not a “state officer” under the […]

Legislature passes bill making long-term care benefits portable

The Legislature has passed SHB 2467, which would allow employees who move out of state to continue to participate in the long-term services and supports (LTSS) trust program. The House passed the bill on Feb. 12 and the Senate passed it (with no amendments) yesterday. (A broader bill that would make benefits portable as well […]

Health Care Authority requests just a 3% increase to its budget, but that doesn’t include the impacts from the caseload forecast

For the 2024 supplemental operating budget, the Health Care Authority (HCA) has requested an increase to its 2023–25 general fund–state (GFS) appropriations of $222.6 million (3.0%). However, that includes several placeholders that will add significantly to the total. Of the amount that is included in the request, $142.2 million is at the maintenance level (the […]

Trueblood-related spending is a major part of DSHS’s budget request

The largest 2024 supplemental budget request is from the Department of Social and Health Services (DSHS). (I wrote about the agency requests overall earlier this week.) DSHS has requested a $775.5 million increase to its general fund–state (GFS) operating budget (an increase of 7.7% over enacted 2023–25 appropriations). Of the new requests by DSHS, 72.4% […]

Washington received an estimated $2.743 billion from the enhanced federal match for Medicaid

During the pandemic, the federal government has been providing an enhanced federal match for Medicaid. Typically, the federal government pays for 50% of Medicaid spending in Washington, and the state covers the other half. (A higher match is in place for some Medicaid clients, pursuant to the Affordable Care Act.) The enhanced pandemic federal medical […]

Medicaid and health care affordability provisions in the budget

In the 2023 supplemental operating budget, as passed by the Legislature, maintenance level changes (the cost of continuing current services, adjusted for enrollment and inflation) increase appropriations from funds subject to the outlook (NGFO) by $400.7 million. The bulk of that ($373.8 million) is from mandatory Medicaid caseload adjustments. However, that is offset by policy […]

The 2021 increase in private long-term care insurance coverage in Washington led the nation

New data from the National Association of Insurance Commissioners (NAIC) show—unsurprisingly—that long-term care (LTC) insurance coverage jumped in Washington in 2021. The 2019 legislation establishing the state’s LTC program exempted people with private LTC insurance policies from the state program. This provision was amended in 2021 to specify that individuals had to purchase private LTC […]