Commission hears strong public support and detailed questions about proposed universal primary care benefit

The Universal Healthcare Commission on April 30 heard a stream of public comments urging the body to advance a "universal primary care" proposal while staff and commissioners pushed for more analysis before committing to a rollout.

Supporters including Sherry McEvoy of Health Care for All Washington and Andre Stackhouse, executive director of Whole Washington, told the commission the idea could be a practical step toward a fully universal system. "We recommend that the UHCC consider the following 3 options for using the $250,000 generously provided by the Office of the Insurance Commissioner," Sherry McEvoy said, urging completion of actuarial modeling and economic analysis to inform benefit designs.

Why it matters: commissioners are weighing whether a primary‑care benefit carved out from existing coverage can reduce avoidable emergency care and improve chronic‑disease management while serving as a bridge to a broader universal system. Staff presenters described a model that would pay primary‑care practices on a capitated basis, embed behavioral health in primary care and use a small standard set of quality measures to reduce administrative burden.

"The concept here is a universal primary care benefit that would be carved out of the traditional health care system," Jane Beyer said in a presentation that framed the proposal as "foundational" rather than final. Beyer described capitated provider payments, risk‑adjustment methods for clinicians serving sicker populations, and potential state umbrella reinsurance to reduce financial risk for smaller practices.

Commissioners and FTAC members asked for specifics on workforce and financing. Laura Kate Zajitkin of the Washington Health Benefit Exchange said spring enrollment for plan year 2026 shows about 40,000 fewer enrollees and roughly 50,000 fewer Washingtonians receiving premium tax credits versus last year — trends that could increase demand for alternative access models. "We are anticipating significant attrition over the course of the year as folks have a hard time paying their higher insurance premiums," Zajitkin said.

Several public speakers urged the commission to prioritize more conservative analysis. "I think the $250,000 would be much better spent by having Milliman complete their analysis of the 3 benefit package options," Chris Curry, a retired nurse and member of Healthcare for All Washington's policy committee, told commissioners.

Staff flagged the OIC proviso (the $250,000) as limited and due to be spent by June 30, 2027; they proposed using it for targeted actuarial or economic modeling that could inform both a primary‑care scenario and a full universal‑coverage scenario. "There are a number of ways to think about [the timeline]," Beyer said, including phasing in by population or program and evaluating legal and federal constraints.

Concerns focused on rural access, unintended market effects and eligibility boundaries. Christina Sarabia, representing the Yakima Valley Healthcare Defense Partnership, said her region has the state's highest Medicaid rates and an urgent need for immediate support: "Urgency is what I'm asking for, and please don't forget Central Washington, Yakima." Commissioners reflected similar worries and asked staff to return with more detailed modeling, eligibility options and implementation road maps.

What’s next: staff proposed a joint commission–FTAC work group and iterative deliverables over the summer, with additional analyses returned to the commission in June and September. The commission did not take a vote on adopting the primary‑care proposal at the April meeting.