This bill amends RCW 41.05.840 to create and define a universal health care commission charged with developing changes to Washington’s health care access and delivery system and preparing the state for a possible unified financing system. The change establishes the commission’s membership (including legislative appointees, state agency heads or designees, six governor appointees chosen with an equity lens, and specified agency representatives), requires the Health Care Authority to staff the commission, sets quorum as a majority of voting members, mandates public meetings and published agendas/materials, and provides that members serve without compensation but are reimbursed for travel under RCW 43.03.050 and 43.03.060. The amendment creates a procedural and planning framework rather than a new criminal or penalty provision: the commission must begin any necessary federal application process within 60 days of availability, may form public advisory committees, and must produce specified deliverables on fixed timelines (a baseline report due November 1, 2022; annual reports each November 1 beginning in 2023; a final recommendations report by December 1, 2027; establishment of finance, citizen, and provider advisory committees by December 1, 2028; and draft legislation to establish a universal health care system by December 1, 2029). The baseline report must include specified items such as an inventory of design elements (including “unified financing system” as an example), readiness assessments, reimbursement recommendations (including a recommendation that providers serving medical assistance clients be reimbursed at no less than 80 percent of comparable Medicare rates), and a finance committee recommendation. The section explicitly does not authorize the commission or authority to implement a unified financing system absent further legislative and gubernatorial action. The amendment names affected state entities and data sources (for example, the Health Care Authority, Department of Health, Washington Health Benefit Exchange, Office of the Insurance Commissioner, Office of Financial Management, State Treasurer, Employment Security Department, and various health data and advisory boards) and requires public access to meetings under chapter 42.30 RCW. Important contextual gaps remain in the extracted text: some deadlines and the commission’s first meeting date precede the bill’s apparent timeline, the term “authority” is used ambiguously in isolation, the content of the referenced Senate Joint Memorial No. 8004 (2025) is not included, and certain appointment details (for example, the scope of an invitation to tribal government representatives) are unclear from these excerpts.

If enacted, the bill creates a state commission charged with studying and planning changes to Washington’s health care system and preparing recommendations for a single, unified financing option. That will require the Health Care Authority to provide ongoing staff support and public meeting administration, impose modest new travel and administrative costs for state agencies and commission members, and produce multiple reports and advisory committees on a fixed schedule; some recommendations (for example, raising reimbursement for providers serving medical assistance clients to at least 80 percent of Medicare rates) could push toward higher payments for those providers if picked up by implementing agencies or later legislation. The commission cannot itself put a unified financing system in place without further legislative and gubernatorial action, so immediate structural change is unlikely but planning, analysis, and possible policy proposals will increase workload and could shift future budget and policy choices. The people and entities most directly affected are the Health Care Authority (new staffing and publication duties), the named member agencies (Department of Health, Health Benefit Exchange, Office of the Insurance Commissioner, Office of Equity, OFM, State Treasurer, Employment Security Department) who must participate in the finance work, and providers serving medical assistance clients who may be recommended higher reimbursement. The text leaves some important details unclear—several deadlines cited are already past, the term “authority” is used ambiguously in places, and the referenced 2025 memorial and the scope of tribal invitations are not included—so how and when recommendations would translate into funding or regulatory changes is uncertain.