Washington Policy Watch

This post was written by EOI Floyd Jones Fellow Brandon Bannister.

Have you ever had a procedure where you figured the cost would be covered by your insurance, then out of nowhere, you ended up with a huge bill for the whole thing? This is called “surprise billing” – or in insurance-company speak – “balanced billing.”

Surprise billing happens when a consumer uses a health care service from an out-of-network provider. These are providers that do not fall within your insurer’s circle who agree to a set rate for services.

When you use an out-of-network provider, they send the bill to your insurance company at a rate they set independently. Insurers may disagree with this price set and either pay a portion of it or nothing at all. Then, they drop anything that remains in your lap and you have to pay the difference, which can be substantial.

A Consumer Union survey from 2015 found that 30 percent of privately insured individuals reported receiving a surprise medical bill in the last year.

It’s not always predictable when a medical service is out of network. Sometimes, an in-network hospital contracts ambulances from an out-of-network provider. Sometimes, a physician in a network hospital isn’t part of that network. The patient may not be aware of this until the bill comes.

Health care is one of the few areas where consumers have no idea what services cost until after they are performed. Often, a doctor doesn’t even know what the hospital will charge, because there are many different rates for different insurance situations. Yet for many of us, bill of a couple thousand dollars can upend our whole lives. According to Bankrate’s 2018 financial security survey, only 39 percent of Americans said they would be able to cover a $1,000 bill using their savings.

With growing outrage around health insurance premiums, insurers are shrinking their provider networks in order to seem more cost effective for consumers. Narrow networks made up 23% of plans offered by employers in 2012, up from 15% in 2007. This can result in lower costs for customers – but only if they are on their toes about which services are becoming out of network, which is exceptionally difficult to manage.

Under the current system, providers and insurance companies have no incentive to be more transparent as they shrink networks, because the status quo costs them nothing.

If we want to make health care more affordable, transparency needs to be addressed before surprise billing spreads like wildfire.

There is no good reason why providers and insurers can’t hash out a price disagreement amongst themselves rather than passing the buck to the consumer. There can be a formal process of arbitration for these price disputes. Illinois has already taken action on this, mandating an independent legal resolution between providers and insurers without involving the consumer. Nine other states have introduced legislation around capping the amount ER’s can charge for out of network services.

For the sake of consumer protection, Washington State should enact legislation around price dispute arbitration and out-of-network emergency room cost capping. Consumers should not be expected to pay high premiums to insurers only to find out their coverage doesn’t work when they need it most.

It’s great that Congress is once again paying attention to the need for time off work to care for family or their own health, but most of us who have fought for paid sick days and paid family leave are groaning rather than cheering.

With much fanfare, Senator Marco Rubio this week introduced the “Economic Security for New Parents Act,” which forces parents to sacrifice Social Security benefits in exchange for a few weeks of paid leave with a new baby.

A House subcommittee also held a hearing on a “Workflex” bill sponsored by Representative Mimi Walters and Washington State’s Cathy McMorris Rodgers, which would allow multistate corporations that offer an ill-defined minimum set of benefits to flout more protective local and state paid sick leave laws.

Members of Congress should reject the bills from Rubio, Walters and McMorris Rodgers, and should instead follow the lead of the states in passing strong guarantees of comprehensive paid leave for all workers.

This week also marks the 25th anniversary of the landmark Family and Medical Leave Act. Passed by Congress in 1993, the FMLA allows many workers across the U.S. to take up to 12 weeks of unpaid leave to care for a new child or seriously ill family member, or to recover from their own health condition. The only major update has been to add leave for issues arising from a family member’s military deployment.

The basic protections of FMLA have been critically important for millions of working people and their families, but the law has major gaps. FMLA doesn’t cover more than 40 percent of workers, because it only applies to companies with 50 or more employees and workers who have been with their employer at least a year and worked at least 1,250 hours the previous year. It does not cover less serious illnesses, such as the flu, or routine health needs, such as staying home with a sick child or going in for a cancer screening. And it doesn’t guarantee that workers will receive pay while out on leave.

In an economy where most kids have all parents in the workforce, growing numbers of workers have elder care responsibilities, and few families can afford to miss a paycheck, guaranteed standards of paid leave are critical to the health and well-being of individuals, families, and communities.

The United States is an international outlier in not establishing general standards for paid sick days or paid parental leave. According to the U.S. Bureau of Labor Statistics, 32 percent of all private sector workers and 70 percent of low-wage workers do not get a single day of paid sick leave. Only 13 percent of private sector workers and 4 percent of low-wage workers get paid family leave. Sick days statistics have improved over the past several years as ten states (including Washington), and over 30 cities (including Seattle and Tacoma) have stepped into the void and enacted laws requiring employers to provide a minimum amount of sick leave.

In 2017 after a lengthy advocacy effort, Washington became the fifth state to adopt a comprehensive paid family and medical leave program. Washington was able to build on the progress and learnings of other states and pass what is in many ways the most generous program, providing progressive benefits that start at 90 percent for low wage workers and top off at $1,000 per week for higher earning workers, covering all workers with full portability between jobs, allowing self-employed and contract workers to opt in, and providing up to 18 weeks of leave in certain cases.

Significantly, business leaders, working family advocates, and members of both parties joined together to craft and pass Washington’s policy.

Earlier this year, Massachusetts adopted a paid family and medical leave program that in some ways tops Washington’s, with job protection (which New York and Rhode Island also have) and up to 26 weeks of leave. Washington, D.C. is also implementing a program.

Working families across the U.S. need Congress to act – but not by reducing Social Security benefits or taking away protections workers have won. The Healthy Families Act and Family Act are far better alternatives. Even better would be following the lead of Washington and other states which are adopting standards and programs that help all workers, families, and businesses thrive.

Thursday, September 20th, 2018
5:30 PM

Your presence is requested – please join us at our 20th Anniversary dinner!
The evening will feature delicious buffet dinner and drinks and an exciting program. We’ll honor our shared victories, be inspired by community allies working for change, and shine a light toward future successes. Your support will help make Washington State a more equitable and just place for everyone to live, work, play and raise a family.



Thursday, September 20th, 2018
5:30 p.m. Social Hour; 6:30-7:30 p.m. Dinner and Program
Fisher Pavilion, Seattle Center ** Please note this year’s new event location!
305 Harrison St.
Seattle, WA 98109


All tickets include our fun social hour (complete with games, music from DJ Riz Rollins and a photo booth!), a delicious buffet dinner and dessert (GF and vegetarian options available) and an educational, inspiring program.

Premium: $250 Includes complimentary parking, premium event seating, take home gift, and special recognition at the event
VIP: $150 Includes special recognition at the event
General admission: $100
Can’t attend? You can still support our work with a regrets donation!


Our program will feature speakers Ijeoma Oluo and Senator Karen Keiser, the first ever recipients of the Aubrey Davis Visionary Leadership Award and the Aubrey Davis Lifetime Achievement Award. Our Master of Ceremonies will be EOI Board President and owner of Plum Bistro Vegan Restaurant Makini Howell.

  • Senator Karen Keiser, Lifetime Achievement Award Recipient 
    During her tenure representing Washington State’s 33rd Legislative District, Senator Karen Keiser has played a key role in advancing equity for working people. Her policy wins include passing and implementing health care reform prior to, and under, the Affordable Care Act, Paid Family and Medical Leave in 2017, the Equal Pay Opportunity Act, and a package of laws protecting workers from sexual harassment in 2018. Sen. Keiser is passionate about helping working families and improving women’s economic security.
  • Ijeoma Oluo, Visionary Leadership Award Recipient
    Ijeoma Oluo is a Seattle-based writer, speaker, and Internet Yeller. She’s the author of the New York Times Best-Seller So You Want to Talk about Race. Named one of the The Root’s 100 Most Influential African Americans in 2017, one of the Most Influential People in Seattle by Seattle Magazine, one of the 50 Most Influential Women in Seattle by Seattle Met, Oluo’s work focuses primarily on issues of race and identity, feminism, social and mental health, social justice, the arts, and personal essay. Her writing has been featured in The Washington Post, NBC News, Elle Magazine, TIME, The Stranger, and the Guardian, among other outlets.
  • Makini Howell, Master of Ceremonies
    Makini Howell is the Economic Opportunity Institute’s Board President and is the creator and owner of Seattle’s Plum Restaurants, which include Plum Bistro, Plum Burgers, Plum Pantry, Plum Chopped, and Sugar Plum. Her work popularizing vegan cuisine through her restaurants and her cookbook “Plum” has earned her national recognition. Makini is also a champion for progressive workplace policies, and was a leader in the campaign for paid sick days and the $15 minimum wage in Seattle.


Parking is available in all Seattle Center lots or on the street. The closest garage is the 1st Avenue North garage, which puts you about 1.5 blocks away from Fisher Pavilion at the corner of 2nd and Thomas. Additional garages are on Mercer Street near McCaw Hall and on 5th Avenue and Harrison.The Seattle Center is accessible by bus, monorail, bicycle, and foot!

Parking is included with the purchase of a Premium Ticket.

Click here to download a Seattle Center map.


Disabled Parking: With a disabled parking permit, you may park all day in a one-hour or two-hour parking spot, of which they are several near the corner of Second and Thomas near the church and on the south side of Thomas Street behind the Seattle Center Pavilion.
Drop Off Locations: Gate 2/3 at the corner of Second and Thomas
Accessible Entries: East elevator and front (north) doors
Elevators/Ramps: East Elevator
Accessible Restrooms: Each restroom has an ADA stall. There are also accessible water fountains inside at both the east and west ends of the building


Event sponsors and table captains power our movement for equity! For more information, contact EOI Development Director Sam Hatzenbeler via email or by phone at (206) 529-6375.































We all seem to be suckers, distracted by the Trumpian antics and losing focus on corporate privilege and compensation. We shrug it off as if to say, “Shit happens.” But if we take some power into our own hands, we can make good things the reality, rather than losing ourselves to a national preoccupation with Donald Trump. The best way to predict the future is to create it.

A federal law still in force from the Obama era requires disclosure of CEO pay of publicly-traded corporations and the ratio to average employees’ pay. The data are starting to dribble in. They are not pretty, especially in our own state.

Expedia CEO Mark Okerstrom made $30.7 million in 2017. That is 431 times the pay of the typical Expedia employee. T-Mobile US CEO John Legere made over $32 million. That is 424 times the median pay of $55,739 for T-Mobile employees. Now we know who is cashing in on those incomprehensible cell phone charges we all seem to get sucked into. It’s not the workers, it’s the corporate elite who rule over them and us.

The median annual wage at Amazon is $28,446. Amazon’s executive officers, not including Jeff Bezos, averaged over $8.6 million a year for each of past three years. Each of these executive officers additionally realized on average $17 million in vested Amazon stock in 2017. These officers and the Amazon Board, minus Bezos, own $593 million in Amazon stock. And of course, the big daddy at Amazon, Bezos himself, has Amazon shares totaling $145 BILLION.

What does this have to do with public services, education, housing, transit, health care? Nothing, because we don’t tax income or wealth in our state. Of course, we could. And then we could begin to fund higher education and early childhood education as the public services they are, not some scholarship gift from another corporation. We could also then lower property taxes and sales taxes that affect the poor and middle-class more than the rich. We could do this right now with an excise tax on executive compensation in our state.

Here is how it would work: for any compensation for an employee that exceeds $1 million, the employer would pay an excise tax on income above that $1 million threshold to fund public services. It is not a novel idea; it’s already in federal law. There is no good reason we couldn’t replicate this in our state.

We could place a 10 percent tax on compensation in excess of $1 million, a 1 percent tax on annual vested stock in excess of $5 million, and 0.5 percent tax on the values of shares owned in the employee’s company in excess of $50 million. That simple mechanism would net about $155 million just from Amazon. That would be enough to offer tuition-free community college for all students for their first year in Washington’s colleges.

Just looking at compensation, not stock, we now have the data for 28 publicly traded companies headquartered in our state. Taxing compensation in excess of $1 million at 15 percent and compensation in excess of $10 million at 25 percent, the state would gain $35 million from these 28 companies. That would enable health care coverage for all early learning caregivers and teachers across the state.

These are net positive trade-offs. Bezos really doesn’t need to spend billions on a private rocket into space. Even though Amazon has been a historically stingy community partner, it’s seems Amazon realizes now that it should at least look like it’s giving back.

We certainly need to open up higher education to all comers, and make sure that the people who care for our youngest children have health care themselves. Taking the excess income and wealth of the corporate elite for public goods and services is good for them, and good for us.

Last month, Washington State reported that 11 insurers filed 74 health plans for the 2019 state Washington Health Benefit Exchange market. The good news: no counties will be without issuer coverage. The bad news: health insurers proposed a 19 percent increase in insurance premium costs.

The rising cost of health care leaves working individuals and families skipping medical care to maintain basic needs like shelter, food, childcare and transportation. President Donald Trump’s executive order to expand short-term duration insurance may seem like it saves money, but in reality exacerbates existing problems and costs more long-term.

The U.S. Department of Health and Human Services has published new rules widening access to short-term insurance, which was originally limited to 90 days and intended to fill small gaps in health coverage. These plans were heavily regulated under President Barack Obama, as they are inferior, falling short of basic minimum coverage protections and deter young, healthy individuals from purchasing through the market place.

Trump’s expansion of short duration plans to 364 days entices people to opt in because of its low cost. But they are actually putting themselves in grave financial peril. If anything goes wrong, the plan likely won’t cover it. While ACA plans prohibiting denial of insurance based on pre-existing conditions, short-term coverage allows it. So if you find out you have cancer, it’s probably not covered. Short-term plans also lack coverage of prescription drugs, mental health, substance abuse, preventative care and maternal care. When you need health care, your insurance won’t be there for you, and you’ll have to pay out of pocket. These skimpy plans set up individuals for financial ruin.

Costs also rise for everyone else. In the United States, unlike other developed countries, health care is a for-profit enterprise. When there are fewer healthy people in the system, everyone else becomes more expensive for insurance companies to cover. To protect their profits, they raise rates. In short, it’s a bad deal for everyone.

As a young person, it can be hard to image your own mortality. But no one is immune from falling ill or having a child diagnosed with a chronic condition. The current administration is marketing the alternative plan as another option but in reality, it’s a poverty trap for individuals and working families.

Currently, about 268,400 individuals purchase their insurance through the individual marketplace in Washington State. With elimination of the individual mandate in 2019, people who don’t think they need good coverage will leave and costs are projected to increase substantially for those who stay.

The Office of the Insurance Commissioner will review proposed plans for various coverage areas this summer. Once the review is complete, the Washington Health Benefit Exchange Board will certify plans for sale on Washington Healthplanfinder beginning September 13. Individuals may enroll for individual 2019 market plans on November 1.

An SEIU protest in 2009. Source: Leadership Conference on Civil Rights

Many progressives are rightfully worried about the consequences of the Supreme Court’s Janus decision, which enables workers to gain the wages and benefits collectively bargained by unions without contributing dues. It is a public-sector version of “right to work” laws that are in force in 28 states.

But we can do things to reinforce the union movement. We can do a lot more than merely say that we are working hard to protect workers and that we stand with union members. We could actually join a union!

Some workers may say that they don’t need a union, that their organizations have excellent working conditions and enable staff input and decision-making on compensation and job descriptions. But the reality is that they remain at the complete mercy of their organizations’ management team. Management changes its mind, and a lot of formal and informal work agreements can go out the window.

Washington is an at-will employment state. This means that an employee can be dismissed by an employer for any reason, without just cause and without warning, as long as the reason is not discriminatory based on protected class status. A union can protect against that. Union members negotiate a collective bargaining agreement that lays down the parameters for workers’ rights, benefits, and wages. The agreement can also address racial and gender equity and work culture.

In our state there are plenty of unions that would be happy to help organize your workplaces. Just call the Washington State Labor Council, the Teamsters, or any number of local unions. The Service Employees International Union (SEIU) has a name that reflects its founding for elevator operators and window washers. Now, like many other unions, they cover a lot of other workers, including those in health care, government, and food service. Workers at our sister progressive policy institute, the Economic Policy Institute, are in the International Union of Professional and Technical Employees, along with the Boeing Engineers.

I must make a disclosure here: the staff at the Economic Opportunity Institute have not decided to organize into a union. But I am a union member! Organizations’ leaders and managers can join unions. While leaders can’t really collectively bargain with themselves, they can become associate members of unions of their choice, showing solidarity with their own dues. Recently I joined SEIU 925 in connection with my position on the clinical faculty of the UW School of Public Health. Other possibilities are Working America which enables workers who don’t have a union at their place of work, or are exempt from those collective bargaining units, to join and show their personal support and solidarity. SEIU has associate members. The Washington State Labor Council can also connect you with associate memberships in several unions.

Those of us who don’t pay dues, whether we are in a union or not, are all free riders. It is the union movement that brought us child labor laws and collective bargaining, which built the middle class. More recently it is the union movement in our state that was the engine for our good minimum wage, our state law requiring paid sick days, and paid family and medical leave, to name a few progressive steps forward. Paying dues is both paying back for past progress and paying forward for our future and that of our children and grandchildren. It is how we can show true solidarity.

The high cost of child care is a major stumbling block for parents of young children. In the greater Seattle area, it costs $17,472 annually for infant care and $15,288 for toddlers, which is more that undergraduate in-state tuition at the University of Washington. Even in less expensive markets, such as Yakima, it’s as much as $8,728 for infant care and $7,128 for toddler care. The child care industry not only nurtures our young children, but also provides a firm basis for a stable workforce and a necessary service for families.

Yet in 2016, Washington’s child care teachers made less money than pet groomers. Furthermore, Early Childhood degrees have the lowest projected earnings of all college graduates.

This is a national problem. In 2017, Senator Patty Murray introduced The Child Care for Working Families Act which demands increased compensation for the workforce, and addresses affordability and access to quality child care for families.

But, we can’t wait for the federal government. State and local lawmakers need to ease the crunch by investing more into compensation for early childhood educators. According to the Bureau of Labor Statistics, there are 9,080 Early Childhood Educators in our state, and the mean annual wage is $27,800.

Early learning providers in Washington are in crisis. Low compensation directly impacts the hiring and retention of staff, which negatively affects programming quality and the ability for centers to stay in business. According to a statewide survey the Economic Opportunity Institute conducted in 2018, 98 percent of center directors expressed concern for their ability to hire qualified staff and 68 percent feel the quality of the programs are compromised because of staff shortages (this data will be available August 2018).

In the race to create quality programming for children, our state forgot to invest in the life-force of this system: early childhood educators. In 2015, the Legislature passed the Early Start Act (ESA) to expand high quality early learning. ESA sustained Early Achievers, Washington’s quality rating and improvement system, which holds providers accountable to their commitment to providing high-quality care. But, little has been done to address the systemic problems created by low wages, high turnover, and other factors influencing the supply and retention of early childhood educators.

Early childhood education teachers who live in poverty are more likely to experience toxic stress, depression, and chronic health issues, contributing to their own economic insecurity and actual poverty while jeopardizing their ability to provide enriching and nurturing environments for children. According to data collected in 2018 by EOI, these factors are also driving early childhood education workers out of the field and into other industries with higher wages and health benefits (this data will be available August 2018).

Investing in high quality early childhood education has proven to be a great investment. For every $100 Washington spends on high quality early childhood education, our economy receives $113 in return. However, that return on investment is only achieved when the care is high quality.

Our state has forecasted 3.9 percent annual employment opportunity growth for early childhood education teachers, with 3,270 positions open year. Additionally, over one-third of the workforce is turning over.

To enable every child a pathway to well-being and educational advancement, we must recruit and retain and appropriately compensate an educated and esteemed workforce.

To learn more about what early childhood educators do on a daily basis for our children, click here.

To learn more about EOI’s research on early learning and what you can do to support increased compensation for early childhood educators and affordability for families, please contact Sarah Clark at sarah@eoionline.org.


One year ago, the Seattle City Council unanimously passed the first progressive income tax in our state in 85 years. This tax on incomes in excess of $250,000 for individuals and $500,000 for families will produce sufficient revenue – more than $200 million a year – to lower property taxes, provide affordable housing and transit, replace federal funding cut by the Trump Administration, create green jobs, enable tuition-free community college for all residents, and fund other public services.

It is a tax that speaks directly to the privilege and power of the top corporate executives and the 1 percent of Seattle residents who have benefited enormously from the ongoing transfer of income from middle- and low-income to wealthy Americans. So it was no surprise that these same wealthy people sued to block Seattle’s income tax. They are represented by the Koch Brothers-funded Freedom Foundation, which is trying to decapitate unions as the organizations voices for workers, and the Pacific Legal Foundation, which succeeded in rolling back civil rights law.

As anticipated, the King County Superior Court ruled against the City of Seattle. According to precedent, subordinate courts do not overturn decisions that were made by the court that has final decision-making power, in this case the State Supreme Court. However, EOI and the City of Seattle have requested direct review from the State Supreme Court. If the State Supreme Court agrees to direct review, then we can expect oral arguments in the fall, and a decision in 2019 or 2020.

While the legal maneuverings proceed, the acceleration of income to the affluent is unabated. Using 2014 IRS data, we projected the City of Seattle would raise about $140 million a year from this tax. Using 2015 data, we now project that the City would raise $170 million a year. As of 2015, 10,000 residents would be contributing to this tax, roughly the wealthiest 2.25 percent of all Seattle households. We also know that Seattle has the most regressive tax system in our state, with people who earn less than $25,000 contributing over 18 percent of their pre-tax income in state and local taxes, and those with incomes in excess of $250,000 contributing less than 5 percent.

The Trump-Proof Seattle Coalition, and, in particular, the Transit Riders Union and EOI, created the political and policy force to move this income tax through the city council. Our opponents would like people to believe that this income tax is dead. It is not!

Indeed, by suing the city of Seattle, our opponents have created the legal pathway to the State Supreme Court, thereby enabling that court to uphold Seattle’s income tax and create the foundation for a progressive and robust tax system, in Seattle, in other municipalities, and statewide.

These legal battles take years. We have good reasons to believe that we will prevail. What the Seattle City Council voted into law one year ago today will be seen, when we look back in time, as a catalytic moment for progressive taxation in Seattle. You helped make that happen. Now we have to be patient and enable our legal teams to do their very best work to ensure that the State Supreme Court upholds this law.

 Thank You and Happy Anniversary!

We have had more than a week of devastating news from Washington DC on immigrants, workers, women, consumers, citizens, and non-citizens. Some of us are hoping to take a break from this madness on the Fourth of July, our country’s Independence Day. It’s a day to celebrate life, liberty, and the pursuit of happiness, to celebrate freedom and justice, and to eat hot dogs.

People should know this celebration is mostly national mythmaking. Not only did Independence Day really occur on July 2, but it idealizes the past. It covers up the reality that our country was not born a democracy. It was born with slavery and genocide. The signing of the Declaration of Independence meant little for the approximately half a million slaves living in the 13 colonies, or for the Native Americans whose land was taken. It did not extend the vote to women, non-whites or property-less people.

Only the already privileged and powerful gained life and liberty with our country’s independence.

We are on the verge of repeating our history. There are more black people in prison now than there ever were slaved in America. American Indians’ rights are trodden upon and ignored – our local version of “Does Flint have clean water yet?” should be “Are the Duwamish a federally recognized tribe yet?”. The impending retirement of Justice Anthony Kennedy means that same-sex marriage and abortion accessibility are under imminent threat.

Trump, in his endless lies and self-aggrandizement, has ripped off the scab of civility from some elected officials. These are mostly Republicans, but also include Democrats, and they are intent on taking apart Social Security and Medicare, ramping up anti-immigrant hatred, and insuring that workers remain powerless. These politicians created the political pathways, the dog whistles, and the calculations for reaction.

For progressives, it’s never been a more depressing time. But it helps to remember that even though there were huge fundamental problems of social justice in 1776, today is more equal than it was. Conservatives didn’t achieve that – they just want the status quo.

Progressives achieved change through constant protest, through consistent action, bit by bit. No one in 1776 would have thought America would be a country where women can vote, a black man can be president, and two men can marry. Those would have seemed insurmountable.

Remember that as you enjoy your holiday. Come back refreshed to fight for justice until your next day off.

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