Legislator of the Month
 |
May 2007
WA Senator
Karen Keiser |
Washington Sen. Karen Keiser has won hard-earned victories for workers without affordable health insurance or paid sick leave. Read on for an interview with Sen. Keiser about the bills she passed.
What is the nature of the problems you sought to address with SB 5930 and SB 5659?
SB 5930 was the outgrowth of the governor’s Blue Ribbon Commission on Health Care Access and Costs. Key areas we wanted to address in this bill were:
- 1) erosion of employer-based coverage, especially among small businesses;
- 2) children without health coverage; and
- 3) to find a way to contain the escalating costs of health care.
SB 5659 ties in with the erosion of employee benefits. Less that half of all Washingtonians have paid sick leave. As a result, it is not uncommon to hear about a new mother having to return to work within a few days of having a child because she can’t afford to be off of work long enough to properly bond with her child. Working parents are forced to make a choice between work and family at a critical time for their new child.
In general terms, what do your bills say?
SB 5930 addresses many areas.
- a. modify provider payments to reward high-quality outcomes, rather than just make payments;
- b. develop evidence-based disease management programs;
- c. develop practices to reduce unnecessary emergency room use;
- d. design a ‘reinsurance program’ to assist individual and small businesses cope with medical costs for seriously ill individuals;
- e. promote dependent health coverage to age 25; and
- f. develop pilot employee wellness programs in four state agencies.
- a. promoting EMR systems to reduce medical errors and improve treatment;
- b. establishing real-time databases for use by prescribers and dispensers of controlled substances; and
- c. allowing health professionals access to online medical resources, such as the University of Washington’s Medical Library.
In a nutshell: We are going to make our health care dollars work smarter, not harder, by improving the product we receive, expanding access to the most cost-effective venue for treatment — doctor’s office vs. emergencies rooms, assisting individuals and small businesses in obtaining health care coverage, and expanding access to electronic information in real time so the best medical outcomes can be achieved.
SB 5659 establishes family leave insurance so an eligible working parent can take five weeks of leave with a stipend up to a $250, with the leave to be taken concurrently with the federal FMLA. The program has several qualifying requirements and protections for businesses, including a provision that businesses with fewer than 25 employees are not required to hold a position for an employee using state family leave.
What obstacles did you encounter when you introduced the bills? What lessons can be learned from your experience?
For SB 5930: The Blue Ribbon Commission was a bipartisan effort which issued recommendations on topics with considerable agreement on low-profile issues. It faced difficulties, however, in recommending major system changes. When crafting and introducing legislation, it becomes much harder to carry agreements forward as you progress from general themes to specific actions, particularly when there are major philosophical divides on how to accomplish your goal. We learned that in any major policy change, you must give sufficient time for stakeholders to evaluate information and provide feedback, and that your stakeholder groups must be inclusive — the larger the policy realm, the larger the group. Even if a stakeholder can only play a small part, the opportunity to be involved can make reaching consensus much easier.
For SB 5659: 70 percent of Washingtonians support paid leave for working families as do many businesses. Unfortunately, considerable misinformation was disseminated by opposition groups which proved extremely hard to counter. While we passed a much more robust program in the Senate, the misinformation and characterizations by large lobbying groups resulted in a much-watered down version being finally passed. In the end, it is probably like any other contentious legislation — you have to make sure your message gets out accurately, is understood and is easily remembered.
What advice would you give to legislators who want to introduce these bills in their own states?
When attempting to make a major health policy change as we did in SB 5930, having high- level leadership from the legislative and executive branches is critical: the governor and key actors in the executive branch; health committee chairs and legislative leaders; business, both large and small; other key stakeholders; and the public. The process cannot be rushed; educating everyone about issues and possible solutions needs to be a large part of the process, such as showing businesses how our current system hurts their bottom line and makes them less competitive with countries with universal coverage.
Just as high-level leadership is crucial in passing a bill to reform health care, a strong effort needs to be made to include business in the family leave insurance discussions, particularly from an educational standpoint. This is where it can be pointed out how such a program can boost productivity by having workers who don’t have to worry about a new family member. And there’s the added benefit to employers of knowing that an employee will return after taking leave, eliminating the need to hire and train someone else and risk of losing an experienced employee.
How effective do you think your bill will be? What more remains to be addressed?
SB 5930: Much will depend on our commitment to making real change and keeping the dialogue active.Dependent coverage, workplace wellness and electronic medical records are relatively simple steps when compared to the major overhaul needed for costs and access.We have taken steps to begin the process but we will need to continually evaluate the direction and outcomes we are receiving, along with keeping lines of communication open to business and other stakeholders as we proceed.
SB 5659: I believe family leave insurance will be extremely effective for our working families. In California, which has a much more extensive program, 90 percent of the usage has been by new parents. Our biggest challenge will be making sure working parents know this leave is available. In terms of the future, we need to address the issue of working families who have severely or terminally ill children, spouses or, as baby boomers age, parents. As of now, they still have to make the choice between work and family, a choice no one should have to make under those circumstances.
What is your background (education, career, etc.)? On which committees do you serve?
I earned my bachelor’s and master’s degrees from the University of California, and did postgraduate work at the John F. Kennedy School of Government and the Eliot School of International Affairs.
I recently retired from the Washington State Labor Council as communications director. I serve in the Washington State Senate as chair of the Health & Long-Term Care Committee; vice chair of the Labor, Commerce, Research & Development Committee; and as a member of the Ways & Means Committee.