Affordable Health Care

All Washingtonians deserve access to affordable health care.

This includes a full spectrum of services, including reproductive health care. Too many Washington families cannot afford or find the care they need.

Bob has a proven track record in fighting for quality, affordable health care.

In a 2022 study, 62 percent of Washingtonians reported having trouble affording health care in the past year and had either rationed their prescriptions, delayed care, or depleted their savings to pay for health care. Eighty-one percent said they worried about affording health care in the future. Bob knows we can do better.

Bob has been leading the fight to ensure every Washingtonian has access to affordable health care. While his opponent voted to repeal the Affordable Care Act multiple times in Congress, Bob successfully defended the Affordable Care Act from the legal attack from the Trump Administration and Republican attorneys general. His Supreme Court victory preserved health care for 825,000 Washingtonians, including those with preexisting conditions. It also prevented painful increases in prescription drug costs for Washington seniors.

Bob then wrote and passed legislation that guaranteed 4 million Washingtonians access to free and reduced-cost hospital care, including most older adults on fixed incomes. He’s also taking on health care monopolies that harm Washington patients.

Supported by nurses and physicians across the state, Bob will take on the big fights, solve problems, and get results that increase access and improve the affordability of care.

Bob’s Record Promoting Affordable Health Care:

Bob has championed increased access for affordable health care for all Washingtonians.

Bob successfully passed a reform ensuring all Washingtonians have access to affordable hospital care. Thanks to the law, “Half of all Washington residents are eligible for free or discounted care.” Washington state is now one of the first states to guarantee financial assistance for hospital care to half of all residents. 4 million Washingtonians are now eligible for at least a 50 percent discount on their out-of-pocket costs at most hospitals. These protections are income-based. If you make up to the state’s median income — approximately $56,000 for an individual and $90,000 for a family of three — you are eligible for at least a 50 percent reduction on your out-of-pocket hospital costs such as co-pays and deductibles. These protections exist no matter what insurance you have, or even whether you have insurance.
Bob helped successfully defend the Affordable Care Act from a legal challenge from Republican attorneys general and the Trump Administration. Bob partnered with 20 other states to defend the Affordable Care Act in court from a Texas lawsuit aimed at striking down the law. President Trump eventually joined the Republican Attorneys General legal challenge. Without the Affordable Care Act, hundreds of thousands of low-income Washingtonians would have lost access to affordable health care, and many more would have faced devastating cost increase. Bob and his coalition of Democratic Attorneys General won a major 5-4 victory at the United States Supreme Court protecting the Affordable Care Act.
Bob took on giant health care systems that harmed patients by acting like a monopoly. These transactions were intentionally made to decrease competition, increase prices, and pad the bottom line at the expense of its patients. One case resulted in a large health system rolling back a proposed merger on the Kitsap Peninsula and paying $2.5 million that Bob directed towards community health clinics.
Bob stood up for taxpayers and patients by taking on health care fraud, including Medicaid fraud that harms the most vulnerable patients by taking money out of the system. Bob recovered more than $100 million from providers that committed health care fraud. And he led the passage of legislation to improve the state’s tools against health care fraud. Newspapers across the state endorsed the legislation. Examples: “In Our View: Renew Tool that Fights Medicaid Fraud,” [The Herald, 1/18/2015] “Legislature should keep simple tool to fight Medicaid fraud” [Seattle Times, 3/30/2015]
Bob held the healthcare industry accountable when it illegally overbilled, overcharged or deceived Washingtonians. For example, he held the nation’s largest large health care system accountable for referring patients to an out-of-network lab without warning, resulting in excessive bills. This is known as “balance billing.” Patients deserve to know what to expect from their medical bills. Navigating our health system is challenging, and this type of unfair and deceptive conduct just makes things harder for patients.
Bob won four lawsuits enforcing Washington’s affordable hospital care law, including the largest case of its kind in history. These four cases resulted in a total of more than $200 million in direct refunds to Washingtonians and debt relief for Washingtonians who were inappropriately billed for the hospital costs.
On Dec. 1, 2023, Bob partnered with the Office of the Insurance Commissioner and sent a preliminary report to legislators on the state of Washington's health care system. In it, recent health care market consolidation and changes for improving affordability are explored. The report and its findings will be used to evaluate policy options to improve the affordability of health care in our state.

Bob Ferguson’s Plan to Increase Access to Affordable Health Care

Protect the Affordable Care Act

Bob’s Republican opponent voted multiple times to repeal the Affordable Care Act. He tried to strip health care from 800,000 Washingtonians, including people with pre-existing conditions. His vote would also have caused Washingtonians on Medicare to lose benefits and pay more for prescription drugs.

That’s dangerous and would take Washington in the wrong direction. As Governor, Bob will protect the Affordable Care Act from attempts to eliminate or gut it. He will guarantee coverage for pre-existing conditions. He will protect Medicaid expansion. And he will promote outstanding leadership at the Washington Health Benefits Exchange to ensure that this critical law is implemented well and serves Washingtonians.

Increase Competition

Health care monopolies grow corporate profits at the expense of consumer and taxpayer cost increases and reduction in the quality of services. Improving competition in the health care industry will enhance services and reduce the cost of care. Bob has been breaking up health care monopolies and fighting collusion in the prescription drug industry. Bob and his team put together a blueprint to increase competition and reduce costs. As Governor, he will eliminate barriers that stifle competition and drive prices up.

For example, Bob will work with stakeholders to restrict non-compete agreements for physicians and other health care professionals that reduce competition, particularly in rural parts of the state. Washington lags behind other states in this regard. Washington blocks non-compete clauses for employees making below $116,500 per year, but physicians are generally above that threshold. Delaware, Massachusetts, New Hampshire, and Rhode Island ban physician non-compete agreements. Indiana prohibits non-competes for primary care physicians. And Florida prohibits these clauses for physicians in rural areas.

Bob will also limit further consolidation by reviewing new mergers or affiliations to ensure patients aren’t harmed when a big health system buys a hospital or clinic in their community.

Under Bob’s leadership, Washington will step up to increase competition and reduce costs.

Improve Protections for Prescription Drug Pricing

High prescription drug costs caused 9 million American adults younger than age 65 to stop taking their medications as prescribed, according to the CDC. That’s unacceptable.

Washington is one of eight states that have implemented programs to address the high cost of prescription drugs. This work is just getting started. As Governor, Bob will appoint members to the Prescription Drug Affordability Board (PDAB) who will center Washingtonians and conduct affordability reviews on common medications to keep costs affordable. He will strengthen the PDAB so it can take action to control prescription drug costs more quickly and expand its authority to negotiate prices for drugs directly. Bob will protect the cap on insulin prices and ensure that Washingtonians never have to spend more than $35 per month on insulin.

Bob will continue to enforce the state's protections against spread pricing by pharmacy benefit managers to save money and reduce costs.

Bob protected the Affordable Care Act as Attorney General, winning a victory at the United State Supreme Court that protected 72,000 Washington seniors on Medicare who would have seen their prescription drug costs increased by more than $1,000 if the Supreme Court had struck down the Act. That’s the energy and commitment he will bring to reducing prescription drug prices as Governor.

Strengthen Apple Health

Apple Health (Medicaid) provides nearly 2 million Washingtonians with preventative care, like cancer screenings, treatment for diabetes and high blood pressure, and many other health care services. The administration of Apple Health is one of the key levers Washington has to increase access to affordable care — leading to a healthier state.

Bob’s administration will put people first, reward innovation, deliver excellent service, and invest in better outcomes. Bob will work with managed care plans to make front-end investments in preventive care to drive down health costs and improve outcomes. He will increase reimbursement rates, which will increase the number of providers who treat Apple Health patients, which will increase access to care.

Expand Washington’s Public Option

Enrollment in Washington's public option (Cascade Select) now makes up more than 11% of Washington Healthplanfinder individual market enrollment. Washington’s public option shows promise, but needs strengthening. Premium increases in public option plans have been lower than for other plans offered on the Exchange. The Public Option provided the lowest-cost Silver Plan in 31 of Washington’s 39 counties. As Governor, Bob will strengthen the public option by seeking a waiver to allow additional federal pass-through funds to be invested in affordability programs designed to reduce consumer out-of-pocket spending on premiums and cost-sharing.

Bob will address insurance coverage gaps by enrolling Washingtonians who lose Apple Health into a default public option plan if they don’t choose another plan.

Reduce Health Costs and Improve Quality

Thanks to Bob’s leadership, Washington leads the country in providing financial assistance for hospital care. More than 4 million Washingtonians — more than half the state population — are eligible for discounts on their out-of-pocket hospital expenses. Those discounts range from 50 percent off to free care. More than 2 million Washingtonians — more than 1 out of every 4 Washingtonians — are eligible for free hospital care, regardless of insurance.

But we can still do better. Washington law does not extend income-based financial assistance protections at hospital-affiliated or other clinics. Increasingly, medically necessary care is being provided at health care clinics. Bob will convene providers, hospitals and legislators to put together a plan to reduce out-of-pocket costs for care provided at hospital-affiliated clinics.

Bob recognizes that health care costs are squeezing Washington’s small businesses, large employers, and union trusts. Bob will work with federal partners to give small employers new tools to continue offering health coverage to their employees. Bob will prioritize partnerships with purchaser groups like the Washington Health Alliance so that the state and employers can coordinate cost containment and quality improvement efforts.

Primary care can save on health costs and improve patient outcomes over the long-term, but today too many patients can’t find a primary care provider who meets their needs. Too few physicians, nurse practitioners, and physician assistants choose a career in primary care. Bob will work to grow our state’s primary care provider workforce through more training slots for doctors, nurse practitioners, physician assistants, and women’s health providers. Bob will work to keep primary care providers in our communities with increased reimbursement rates, loan repayment, and other supports for providers of color and those who choose to practice in underserved or rural areas.