It’s one of a slew of health care reform bills to surface in the first week of the Legislature, ensuring that health care will be prominent on the legislative agenda even though Gov. Chris Gregoire proposed no major health initiatives in her 2008-09 supplemental budget or her State of the State speech.

House Bill 2536 would create a nine-member Health Care Working Group to conduct public forums around the state on proposals to improve health insurance access and affordability. About 700,000 Washington residents have no health coverage, and officials say thousands more are one health care crisis away from bankruptcy because of high co-pays and deductibles, and coverage gaps in their policies.

The bill, introduced by House Health Care Committee Chairwoman Eileen Cody, D-West Seattle, and supported by a broad coalition of labor and health provider groups, would authorize the working group to contract for an independent economic analysis of four separate proposals and report its findings to the House and Senate health care committees by Dec. 1.

The four approaches are:

• Allowing health carriers to offer a health plan with a limited scope of benefits, an approach opposed by Democratic leaders but favored by many Republicans.
• Expanding the fledgling Health Insurance Partnership, created by the 2007 Legislature, to include individuals and large employer groups as well as the small businesses it was designed to serve.
• Providing a guaranteed state benefit to all Washington residents.
• Covering all Washington residents, except those covered by federal health insurance, state prison inmates and new arrivals in the state, through a health insurance pool funded with contributions from both employers and workers.

"What we’re looking forward to is a very robust discussion among our citizens about what we want from our health care system and how we can get there," said Robby Stern, an organizer for the Washington State Labor Council and director of the newly formed Healthy Washington Coalition.

The coalition includes the powerful Washington State Hospital Association, Washington State Medical Association, Group Health and AARP, as well as labor unions and business representatives.

At a rally on the steps of the state Insurance Building on Wednesday, about 100 coalition members called on lawmakers to lay the groundwork this year for major health care reforms in 2009.

State Insurance Commissioner Mike Kreidler addressed the rally, describing his proposal for a vote on an initiative that would guarantee catastrophic health coverage for every Washington resident. Under his proposal, the state would pick up catastrophic medical costs exceeding $10,000 for the uninsured and also provide preventative care.

Ingrid McDonald of Washington AARP told the House Health Care Committee that her organization strongly supports a wide-ranging discussion of alternative health care systems, noting that baby boomers between the ages of 55 and 64 "feel handcuffed to their jobs" under the current system.

They’re too young for Medicare, she said, but when life circumstances or failing health force them to retire early, "many are forced to take a gamble that they will be OK until Medicare kicks in."

Other health care-related proposals circulating this week would:

• Increase scholarships and loans to medical students to encourage them to enter the field of primary care, which is experiencing a shortage of physicians as most medical students choose to train for high-paying medical specialties.
• Restrict drug companies from purchasing physicians’ prescribing histories in order to market their pharmaceutical products;
• Expand the insurance commissioner’s authority to review and approve rate changes in the individual health insurance policy market;
• Tweak the Health Insurance Partnership, a small pilot project set up by the 2007 Legislature to subsidize health insurance premiums for workers with incomes below 200 percent of the federal poverty level.

State health officials said at Thursday’s hearing that several changes are needed to make the program work. Limits will be needed on employees’ ability to choose a health plan; funding is required to pay for administering the plan and subsidizing premiums; and coverage will be delayed until March 2009. Gregoire included no money to assist workers with policy premiums in her budget.

Rep. Bill Hinkle, R-Cle Elum, said the program is turning into "a huge bureaucratic nightmare," and he predicted it will do little to help uninsured workers.

And Mark Johnson of the Washington Retail Association said the partnership bill "will create a parallel program that competes with association health plans" if it offers subsidized premiums.

But the Healthy Washington Coalition’s Stern said that although the pilot program isn’t perfect, it fills a gap. "We need this pilot so we can reach the employees that association plans don’t reach."

There’s more to come next week on the health care front.

On Monday, state Sen. Karen Keiser, D-Kent, who chairs the Senate Health and Long-Term Care Committee, will unveil her own bill to bring comprehensive health care coverage to all Washington residents who don’t qualify for Medicare, Medicaid or some other publicly funded program.

Her legislation, not yet introduced, would be paid for through a combination of employer and employee payroll deductions. She said it would give families broad choice over coverage and the doctors they see and would allow them to have access to treatments not covered under most insurance plans.

With Keiser on Monday will be Wisconsin state Sen. Jon Erpenbach, who will describe the Wisconsin universal health care program on which her legislation is modeled.

"Health care reform is back on the table," Keiser said in a statement. "People across the state are clamoring for change. Washington is going to lead the charge in making it happen."

Kathie Durbin can be reached in The Columbian’s Olympia bureau at
kathie.durbin@columbian.com or 360-586-2437.