If the government was just getting out of the business and letting people be their own employers, that would be fine. But that’s not exactly what they are doing. I gather that they are forming a semi-private entity that the home health workers will be forced to be a part of (if they want to keep their career.)

It won’t be truly privatized. Full privatization would allow individual workers to form their own companies and not unionize themselves, and the union-backed politicians don’t want to allow that. This semi-privatization isn’t going to lower costs; the article says Washington State’s Office of Fiscal Management actually.expects costs to rise by $11 million.