Blog

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 […]

Two opposing views on Washington’s long-term care program

The Forefront blog of Health Affairs has published two counter-takes on WA Cares, Washington’s delayed long-term care program. One considers WA Cares a failure, and the other (while acknowledging some problems) considers WA Cares a model. I wanted to add some context for both. (Technically, WA Cares is the long-term services and supports trust [LTSST] […]

Based on actual long-term care program opt-out data, the payroll tax rate will need to rise by an estimated 0.036%–0.061% to maintain solvency

As we noted in our 2021 report on the state’s long-term care program, it looks like the 0.58% payroll tax rate for the program will not be high enough to maintain actuarial solvency. By statute, the premium rate for the long-terms services and supports trust (LTSST) program (also known as WA Cares) cannot exceed 0.58%. […]

Medicaid savings and Washington’s long-term care program

Since our report last year on Washington’s now-delayed long-term care program, the Office of the State Actuary has published new information on Medicaid savings and private opt-outs. (I’ll write about the opt-outs in another post). The long-term care program is technically called the long-term services and supports trust (LTSST) program, but it is commonly known […]