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Board backs registering support for bill to strengthen exchange‑plan access as county warns of FPHS funding cuts
Summary
Board members heard that ESSB 6210 would add certification criteria to the Health Benefit Exchange to improve plan access in underserved counties such as San Juan; the board agreed by head nod to have the county lobbyist register support, and staff warned that unresolved vape‑tax and budget moves could cut the county's FPHS funds by roughly 40%, about $500,000 a year.
San Juan County Board of Health members on Feb. 18 discussed state legislation aimed at improving access to health plans on the Health Benefit Exchange and directed staff to register the county’s support for the exchange‑access bill while raising alarms about potential public‑health funding cuts.
Dr. Harley presented county coverage trends, saying San Juan County’s uninsured rate was about 6.8% in 2023 with a small downward trend into 2024. He noted Apple Health (Medicaid) enrollment in the county declined from about 19.4% to 18.6% in an 11‑month comparison, and exchange plan enrollment fell from about 14.9% (spring last year) to 13.7% (January). Dr. Harley and staff warned the Exchange expects another roughly 10% drop from passive disenrollment this spring.
Staff and board members highlighted Engrossed Substitute Senate Bill 6210, which would allow the Health Benefit Exchange to add certification criteria to ensure plan access and affordability (the Exchange has identified San Juan County as a designated underserved county). Council member Paulson and others urged local testimony; because of short notice and scheduling conflicts, the board asked county lobbyist Josh Wiese to register San Juan County (and/or the Board of Health) as being in support of ESSB 6210 and related fixes (including consideration of SB6129). The chair confirmed online and in‑room members by head nod consented to that plan.
"I think it's appropriate that San Juan County stand up and actually have our name affirmatively signed on to that," Council member Paulson said, arguing the bill speaks directly to local access problems.
Board members also discussed insurer opposition. Paulson and others noted that providers such as Ambetter, Premera and the Association of Washington Healthcare Plans oppose the bill; Dr. Harley encouraged community testimony that emphasizes on‑the‑ground access impacts.
The board also reviewed broader funding risks to the public‑health system. Staff described a vape‑tax reclassification that diverted roughly $20 million at the state level and warned that, if the governor’s budget reductions and the vape‑tax issue were not resolved, the state’s FPHS funding could be cut by about 40%—a hit that Mark Tompkins estimated could translate into "a little over half a million dollars" for San Juan County per year (Tompkins said the county receives "not quite $1,500,000" in FPHS funding overall). That reduction would principally affect workforce funding and local public‑health programs.
Members flagged another bill, HB2720, which would require managed‑care organizations to contribute a small per‑enrollee amount (staff cited roughly $0.54 per person annually) into mental‑health and crisis services that could flow to BHASOs and mobile response/co‑response services; Paulson said that bill cleared the House and moved to the Senate.
Next steps: staff will ask the county lobbyist to register support for ESSB 6210 and related fixes, circulate talking points for anyone who can testify with short notice, and continue tracking FPHS budget signals and vape‑tax fixes. Several board members requested updates at the next meeting on how these bills and budget developments would affect local programs.
