Bending the Health Care Cost Curve: A Look at Washington’s State Employee Health Plan Approach

Health care costs continue to rise, largely driven by increasingly high prices charged by hospitals. This trend impacts patients, employers, and state and federal governments in significant ways – costs go up, health care value stagnates, quality does not improve, and health inequities are made worse. With cuts to state budgets and Medicaid programs looming, policymakers are increasingly pursuing solutions to lower hospital prices in order to reign in soaring health care spending. 

One emerging solution available for state policymakers is to directly limit the prices hospitals charge by implementing reference-based pricing within programs states run or regulate.  During Washington’s 2025 legislative session, United State of Care (USofCare) provided support for Senate Bill 5083, successful legislation which restructures the way the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) plans pay providers for primary care, behavioral health, and hospital services by implementing this policy solution.

USofCare’s newest resource dives into how Washington’s approach rebalances health care spending to save money in the state budget, lower health care costs for state employees, and increases preventative care investments, while providing insights into how advocates and policymakers to replicate this effort in their own state.