Universal Health Plan Governance Board : May 2026 Meeting Summary

Universal Health Plan Governance Board May Meeting Summary

May 21, 2026

Big Picture

The Board focused on:

1. Community engagement and public feedback

2. Administrative savings assumptions and revenue modeling

3. Revenue policy decisions and final report development

Community Engagement & Communication

• Continued outreach to disability-affected communities.

• Town hall survey results to be presented at the next meeting.

Administrative Savings & Revenue Modeling

• Dr. William Hsiao (Harvard) presented on how a unified health system could reduce administrative costs, billing fraud, and duplicative spending.

• Board reviewed Billing and Insurance Related (BIR) cost savings assumptions:

  • Conservative: 7–9%, Moderate: 9–11%, Ambitious: 15–17%

  • Board adopted a 12% administrative savings assumption.

  • Milliman expenditure estimates will be revised accordingly.

Revenue Plan

• Board reviewed the final daft of the Revenue Plan from ECOnorthwest.

• The Finance & Revenue Committee considered the work unfinished.

• The Revenue Plan includes:

  • Universal Health Plan expenditure targets

  • Proposed revenue mechanisms

  • Household and business impact analysis

  • Reserve recommendation (3-month target, 1-month trigger)

• The Legislative Revenue Office is helping convert the proposal into a legislative-ready package.

• Tax calculator under development to compare current health care costs with projected Universal Health Plan contributions.

Revenue Plan Votes

Household Size Rate Readjustment (HSRR)

• Would have required larger, higher-income households (>200% of the Federal Poverly Level) to contribute more.

• Concerns included increased costs for families and added complexity for voters.

• Board voted to remove the HSRR.

Medicare Part B Premiums

• Discussion on whether Universal Health Plan should cover premiums for Medicare enrollees, or reimburse enrollees via a tax credit.

• Motion passed (7–1) to have Universal Health Plan cover Medicare premiums and eliminate the proposed tax credit.

Vote on the broader revenue strategy was postponed.

Final Report Development

• Work continues on: administrative structure, financing structure, supporting materials (history, public comments, consultant reports)

• Updated drafts will continue to be released for Board review.

Public Comment

• Recommendation for a multi-year startup plan.

• Concerns that financing proposals could increase costs for families with children.

• Concerns that larger families should not pay more simply because they use more health care.

Next Steps

• Revise expenditure estimates using the new administrative savings assumption.

• Continue public engagement.

• Finalize financing recommendations and September report.

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Questions? Email: EmmaOppenheim@hcao.orgZ