During another panel at the 2025 Washington State of Reform Health Policy Conference, we learned more about how Washington state has embarked on several key initiatives aimed at advancing health equity, addressing disparities in health care access, and improving care for underserved communities.
These efforts, led by Romilla Batra, Patricia Egwuatu, Lee Che P. Leong and Vanetta Abdellatif, focused on breaking down systemic barriers affecting immigrants, people of color, and low-income populations.
Expanding health care coverage
One of Washington state’s most significant achievements in health equity is the expansion of Apple Health, the state’s Medicaid program.
As Lee Che P. Leong explained, the expansion ensures that individuals, regardless of immigration status—particularly pregnant people, children, and those seeking postpartum care—are eligible for health care coverage. By making health services more accessible, the state is directly addressing disparities in coverage for historically marginalized communities. However, affordability remains a persistent challenge. Many individuals still struggle with the cost of care, even with subsidies or tax credits. Additionally, enrollment rates among non-English speakers remain low due to insufficient outreach efforts. Expanding outreach and ensuring affordability are key next steps toward making health care accessible to everyone.
Oral health equity
Oral health has long been an underserved area in the broader health care system, and Washington is working to correct that. While Medicaid currently does not cover dental services, certain initiatives are attempting to fill the gap by connecting underserved populations with necessary dental care. This includes Access to Baby and Child Dentistry (ABCD) and Dentist Link, led by Vanetta Abdellatif, President and CEO of the Arcora Foundation. Additionally, the state is exploring broader systemic solutions, such as expanding water fluoridation, to address the root causes of oral health disparities. These efforts aim to ensure that dental care—an essential aspect of overall health—is available to those who need it most, particularly in low-income and rural communities.
Addressing behavioral health disparities
Behavioral health has historically been overlooked in discussions about health equity, but Washington state is making significant strides in this area.
One key initiative is the integration of behavioral health specialists into primary care settings—a move toward a more holistic and accessible care model. Dr. Romilla Batra, Chief Medical Officer of Premera, explained that this is especially crucial in rural areas where behavioral health services are scarce, and stigma often discourages people from seeking treatment.
By embedding mental health services in general care settings, Washington is making it easier for individuals to access the support they need. These integrated care models aim to bridge the gap in services, ensuring behavioral health care is more accessible and less siloed between specialities.
Expanding access through public and private partnerships
Private health organizations play an equally important role in advancing health equity in Washington.
Blue Cross has focused on improving health care outcomes for Black and Native American communities in Washington and Alaska, especially in areas like behavioral health and hypertension. Similarly, Kaiser Permanente is committed to reducing health disparities by partnering with community-based organizations and expanding its virtual care offerings, making health care more accessible for individuals facing logistical or financial barriers to in-person care.
These partnerships take a collaborative approach to connecting underserved communities with the care they need, while tackling social determinants of health, such as housing and food insecurity..
Building trust through patient-provider cultural congruence
A critical component of advancing health equity is ensuring that the provider population reflects the diversity of the communities they serve. This patient-provider congruence fosters trust and better communication between health care providers and patients, particularly in underserved communities.
Programs like Kaiser Permanente’s residency program emphasize recruiting health care professionals who possess not only clinical expertise but also diverse life experiences. By prioritizing cultural competency and cultural humility, these programs aim to build a provider network that mirrors the communities they care for, helping to address barriers to access.
Kaiser Permanente’s residency program plays a significant role in preparing the next generation of primary care providers. As a primary care provider herself, Dr. Patricia Egwuatu stated the importance of fostering talent in this crucial role. By offering residents exposure to care models that prioritize accessibility, equity, and outcomes for diverse populations, the program equips them to deliver culturally responsive care.
Prioritizing mammogram screenings for underserved populations
There are persistent disparities in access to mammogram screenings, particularly in low-income and rural communities. To address this issue, Washington state has expanded access to mobile mammography services, allowing women in underserved areas the opportunity to receive screenings without having to travel long distances.
Additionally, Kaiser Permanente and other health care providers have launched culturally sensitive outreach efforts to encourage women, particularly in BIPOC communities, to take part in these screenings. Community health workers and local organizations play a pivotal role in overcoming cultural and language barriers, helping to alleviate fears and build trust.. Initiatives like these ensure that life-saving screenings are more accessible and culturally competent, ultimately working toward early detection and better health outcomes for all.
Moving toward health equity
The initiatives we saw discussed in this panel went beyond simply improving access to care. Washington’s approach serves as a model for other states, setting the stage for a more just and equitable health care system that meets the needs of every community, regardless of race, income, or immigration status.