Comment: A fair tax code is a health care issue. Here’s why.

Published 1:30 am Friday, March 27, 2026

As a nurse practitioner in a busy urgent care clinic in Everett, I never know what kind of patients will need help over my 12-hour shift. My day could start by treating someone with the common cold or a broken bone. I might see someone with a chronic condition, a child with asthma, or an adult in a mental health crisis. I could have a follow-up with a patient I saw last week or help a new patient connect to social services.

But no matter which exam room I walk into, I’m finding many more patients with extremely scarce resources. They are unable to afford their care, pay for follow ups, or pursue diagnostic tests I order.

It’s clear from my exam room to the aisles of the grocery store that there’s an affordability crisis. Wages are stagnant and prices keep rising. It’s hard enough for working families to keep up; they’re not even trying to get ahead.

As someone who entered nursing to care for my neighbors and have a positive impact on their health, I’m frustrated. I see firsthand how the economic stability of my patients has a direct impact on their health outcomes. The disparities I see are only made worse by our upside-down tax code.

Our state budget relies on a few streams of revenue and those aren’t keeping up with our state’s needs. To make matters worse, when the economy is struggling, lawmakers cut the kinds of programs people need most, like health care, food stamps, child care, and education.

We can do better. State lawmakers just passed a Millionaires Tax that would ask the wealthiest people in our state to chip in a little more by paying a 9.9% tax on everything they make over $1 million. The revenue generated from the tax will go a long way to help stabilize our state budget and fund the programs that are vital to everyone in our communities.

If you’re wondering how our tax code has a direct impact on health care, let me describe a situation that anyone working in a primary care setting will recognize. A mom, working full time to provide for her family, has private health care coverage through an employer. But the high deductible limits how often she and her kids seek care. Patients like her may have a diagnosis like diabetes, but don’t get care as often as they need. They miss treatments because they’re out of financial reach, but then they contract a skin infection that could have been prevented. Or they come to my clinic with chest pains and heart complications because they couldn’t afford their medications or routine tests to monitor their diabetes.

Our upside-down tax code means my patient pays a greater share of her income in state and local taxes, while those with the most — the wealthiest 3% — pay lower rates. She’s paying more in taxes and a lot for the basics, forcing patients like her to kick the can down the road by putting off easier, less expensive preventions now and making a worse trade for dire, more acute interventions in the long run.

The federal cuts to Medicaid will only make things worse. There are entire hospitals in Washington at risk of closing because they will lose millions in federal funding. That extra drive to the next town or county will make care too difficult for many to access.

Most of us — whether we were born here or just arrived — believe in taking care of each other. Indeed, that’s why I chose nursing as a profession. I understand the life-saving supports that people in our community need. Like thousands of students, I relied on Medicaid for health care coverage. It was the only way to afford an appointment with a doctor or prescription for medication.

By making investments in basics — health care, food access, education, and child care — we can keep Washington resilient and healthy. The new Millionaires Tax will make this a place where we truly take care of each other.

Justin Gill, DNP, APRN, RN is an urgent care nurse practitioner in Everett, and the President of the Washington State Nurses Association.