It’s the fifth week of the legislative session and things are moving quickly! This past Monday was the fiscal cutoff date, so anything requiring funding that did not pass out of the fiscal committee is now considered dead. There is an exception for those bills considered necessary to implement the budget (NTIB). The next deadline is fast approaching: the “chamber of origin” cutoff is next Tuesday, February 13th. Bills need to be passed out of their originating chamber by that deadline or they will be considered dead. We expect there will be lots of floor action leading up to that deadline.

Here’s a round-up of select health care bills that could impact health access, affordability, and equity – though note this is not an exclusive list! 

Key health bills that have passed one chamber: 

• Health Care Cost Transparency Board – ESHB 1508 strengthens the work of the state’s Health Care Cost Transparency Board (HCCTB) by creating an ongoing survey of underinsurance trends, adding consumer seats to the HCCTB advisory committee, and requiring insurers and providers that exceed the state’s health cost goals to participate in an annual public hearing. This bill has been a NoHLA priority as part of the Fair Health Prices WA effort. Passed the House. 

• Nothing About Us Without Us – 2E2SHB 1541 requires statutory entities to include participation of underrepresented populations who have lived experience in workgroups, advisory committees and task forces. This bill has been a priority for people experiencing disabilities and others. Passed the House.

• Behavioral Health Scholarships – HB 1946 creates scholarships for behavioral health care providers who serve in underserved behavioral health areas. Passed the House. 

• Protecting Preventive Services – HB 1957 ensures Washingtonians with state-regulated health plans can continue to access a full range of preventive services that would otherwise be threatened by the ongoing Braidwood v. Becerra litigation.  Passed the House. 

• Reducing the Cost of Inhalers and Epinephrine Autoinjectors – SHB 1979 requires state-regulated health plans to limit cost-sharing for at least one kind of inhaler and epinephrine autoinjector to $35 for a 30-day supply. Passed the House. Another epinephrine bil (SB 5775) didn’t make it past cut-off. 

• Keep Our Care Act – SB 5241 gives the Attorney General oversight, compliance and enforcement authority to ensure health care consolidations do not affect access to affordable quality health care. This bill has been a NoHLA priority as part of the Fair Health Prices WA effort. Passed the Senate.  

• Uniform Telemedicine Act – ESSB 5481 allows a provider to establish a relationship with a patient using telehealth and would set the circumstances when an out-of-state health care provider may use telehealth to provide services to a patient in Washington. Passed the Senate, set for hearing in the House. 

• Apple Health Prenatal & Perinatal Health Outcomes – 2E2SSB 5580 expands income eligibility for Apple Health pregnancy/postpartum coverage to 210% of the Federal Poverty Level and improves supportive prenatal and perinatal services. This bipartisan bill will make important strides for equitable access to care. Passed the Senate. 

• Expanding family members as individual providers – (DSHS request) SB 5811/HB 1969 would expand the list of family members who can serve as an “individual provider” of home-based long-term care services without needing certification. Passed the Senate, pending in House Rules. 

• Audio-only Telemedicine – SB 5821 modifies the definition of “established relationship” related to health plan reimbursement for audio-only telemedicine, creating a uniform standard for both Essential Health Benefits and non-Essential Health Benefits services. Passed the Senate. 

• Guardianship & Conservatorship – 2SSB 5825 requires the Office of Public Guardianship to contract with public or private entities to provide public decision making services for individuals who are currently receiving care in a hospital setting who are ready to discharge and do not have a guardian. The bill also makes changes to the Uniform Guardianship Act. Passed the Senate. 

• Psychiatric Bed Certificate of Need Exemptions – SSB 5920 extends Department of Health authority to grant certification of need exemptions related to increasing psychiatric bed capacity until 2028. Passed the Senate.

• Licensing Interpreters and Translators – ESSB 5995 requires the Department of Licensing to develop a licensing program for spoken language interpreters and translators. It is unclear whether this bill would help address the current medical interpreter shortage in Apple Health and other health care settings. Passed the Senate, set for hearing in the House. 

• Hospital At-Home Services – ESSB 6101 requires the Dept. of Health (DOH) to establish standards and rules to add hospital at-home services to the services a licensed acute care hospital may provide. Exempts hospital at-home services from certificate of need, home health, and hospice rules.  Passed the Senate.

• Apple Health Prenatal & Perinatal Quality Metrics – SB 6148 requires HCA to collect and report on a broader set of maternal and perinatal health quality metrics. Passed the Senate. 

• Universal Health Care – ESJM 8006 petitions the federal government to help states create a universal health care system. Passed the Senate. 

Key health bills that are awaiting a floor vote: 

• Mandating fertility services – HB 1151 requires large group state-regulated health plans and state employee plans to cover infertility diagnosis/treatment and standard fertility preservation services. Pending in House Rules.

• Tribal Involuntary Treatment Act –  HB 1877 includes tribes, Indian health care providers, and tribal entities in processes under the Involuntary Treatment Act. Pending in House Rules.

• Young Adult Behavioral Health Support – HB 1929 establishes housing and behavioral health supports for 18 to 24 year-olds exiting inpatient behavioral health treatment. Pending in House Rules.

• Abortion Prescription Drug Labels – HB 2115 allows the label for an abortion medication to include the prescribing provider’s National Provider Identifier or the health care facility name instead of the provider’s name. Pending in House Rules.

• Certificate of Need Modernization – HB 2128 creates a task force to examine the state’s Certificate of Need (CON) process. NoHLA has questions about how changing CON would impact community input in health planning. Pending in House Rules. 

• Vaccination Definition – (DOH request) HB 2157 updates the definition of vaccination in state law to include all FDA-approved immunizations recommended by the CDC. Pending in House Rules.

• Children’s Behavioral Health Workgroup – HB 2256 increases the members, expands the focus, and extends the timeline for the workgroup to support improving access to BH for children and families. Pending in House Rules.

• Substance Use Disorder Treatment – HB 2319 makes a number of changes related to public and private insurance coverage of substance use disorder treatment (SUD), including setting minimum authorization periods for inpatient/residential treatment. Note that this bill has some similarities to SSSB 6228 but they are not companions.  Pending in House Rules. 

• Exchange Standardized Health Plans – HB 2361 requires the Exchange to limit the “non-standardized” health plans it offers through Washington Healthplanfinder, ensuring people can more readily find Cascade Care plans that have standardized out-of-pocket cost-sharing levels approved by the state. This bill was weakened coming out of committee and we hope it will be restored. Pending in House Rules. 

• Interagency Coordinating Council on Health Disparities – (Request by Interagency Council on Health Disparities) HB 2346 makes a number of changes to the Governor’s Interagency Coordinating Council on Health Disparities, including changing the vision for the group and membership/structure. Pending in House Rules. 

• County Hospital Funding – HB 2348 authorizes counties to use county money, levy taxes, and issue bonds to pay, finance, or refinance capital expenses related to a county hospital (such as Harborview). Pending in House Rules.

• Pharmacy Benefit Managers – SSB 5213 requires Pharmacy Benefit Managers to register and report to the Insurance Commissioner (separately from other health care benefit managers) and regulate certain aspects of PBM business practices. Pending in Senate Rules. 

• Mental Health Advance Directive (MHAD) – SB 5660 requires the Health Care Authority (HCA) to create a workgroup to develop recommendations to establish the creation, storage and sharing of MHADs, as well as develop model documents and trainings. Pending in Senate Rules. 

• 23-hour Crisis Facility for Minors – SB 5853 would allow the new 23-hour Crisis Relief Centers to serve children, but only in a separate treatment area and with separate policies/procedures. Pending in Senate Rules. 

• Ending Ground Ambulance Balance Billing – SB 5986 bans out-of-network “surprise” bills, aka balance bills insured people often receive today when ground ambulance services are not in-network. This bill has been a NoHLA priority as part of the Fair Health Prices WA effort. Passed the Senate.. 

• Public Health Standing Orders – (DOH request) SB 6095 allows for DOH to issue a prescription or standing order for a drug or device for the purpose of controlling a threat to public health. Pending in Senate Rules.

• Behavioral Health Coverage – SSSB 6228 makes a number of changes related to public and private insurance coverage of substance use disorder treatment (SUD), including defining medical necessity in relation to ASAM Criteria and setting minimum authorization periods for inpatient/residential treatment.  Note that this bill has some similarities to HB 2319, but they are not companions. Pending in Senate Rules.

Many health-focused and other bills didn’t make it out of initial committees and are likely dead for this session, unless aspects are raised in the budget. Select bills that appear to have died include: 

• Biomarker Testing – HB 1450 would have required state-regulated private and public health plans to provide coverage for biomarker testing when supported by medical and scientific evidence.

• Long-term Care Resident Rights – HB 1859 would have extended existing federal rights for nursing home residents to residents of assisted living facilities, adult family homes, and veterans’ homes.

• Right to Repair – HB 1933/SB 6276 would have supported consumers’ right to repair certain products, including the repair of wheelchairs and other items associated with disability accommodation and access. 

• Fair Provider Contracting – HB 2066 would have prohibited the use of certain anti-competitive provisions in contracts between health insurers and hospitals/providers. This bill would have also set guardrails on patient notification when a provider-carrier contract is at risk for termination. This bill was a NoHLA priority as part of the Fair Health Prices WA effort.

• Eliminating Garnishment from Medical Debt Cases – HB 2119 would have prohibited garnishing wages when a court judgment arises from medical costs.

• Medically Necessary Standard for Behavioral Health – HB 2145 would have made a number of changes to coverage of behavioral health services, including requiring insurers to use the same medical necessity standard for mental health and substance abuse disorder treatment.

• PEBB Retiree Medicare – HB 2188/SB 6139 would have lowered health care costs for PEBB retirees by increasing the portion of the Medicare premium paid by the state.

• Creating American Sign Language Workgroup – HB 2221 would have established a work group to address the shortage of qualified and certified ASL interpreters and Protactile interpreters.

• Prohibiting Facility Fees – HB 2378 would have prohibited health care providers from charging patients an extra “facility fee” bill, except where services are provided on a hospital campus. NoHLA testified in support of this bill (at 1:10). 

• Birth Doula Care  – HB 2350/SB 6271 would have required culturally congruent care be provided by birth doulas.

• Involuntary Treatment Act – HB 2469 would have made a number of changes related to civil commitments and required HCA to convene focus groups and develop training programs to improve involuntary civil commitments.

• 30-Day Emergency Insulin Supply – SB 5776 would have required HCA to establish an emergency insulin program to allow eligible individuals to access one emergency 30-day supply of insulin for $10. 

• Prescribing Psychologist – SB 6144 would have created a new category of mental health treatment provider, a psychologist that can prescribe psychotropic medications and order related tests.  

• Respite Care for Caregivers – SB 6126 would have increased access to respite care for those with intellectual or developmental disabilities and their caregivers through the Basic Plus and the CIIBS program waivers. 

• Prescription Drug Coverage for Obesity – SB 6182 would have required Medicaid managed care plans and state employee health plans to cover certain prescription drugs for people with obesity.

• Dental plan requirements – SB 6218 would have required dental plans to meet  certain consumer protection standards, such as dental loss ratio and premium rate review requirements.

• Charity Care Residency Restrictions – SB 6257 would have restricted the definition of who is eligible for charity care to Washington state residents and those needing emergency care. NoHLA and others had concerns with this bill. 

We’re also monitoring other bills that appear to have died, but may reappear as part of budget discussions given their fiscal impact, such as: 

• Covered Lives Assessment – HB 2476/SB 6309 would create a new tax on Apple Health managed care and fully-insured individual and group health plan members, with the goal of drawing down federal matching funds to increase Medicaid payment rates for professional services to Medicare levels. NoHLA is evaluating equity implications. 

• Apple Health Continuous Coverage for Children – SB 5926 would ensure that all young children found eligible for Apple Health can retain coverage from birth until their sixth birthday, regardless of income or household composition changes during that time. This bill would have extended an existing Medicaid policy to more children at the CHIP income eligibility level. NoHLA hopes to see this funded in the budget. 

Finally, NoHLA is monitoring ballot initiative proposals related to health care that the Legislature is considering this session, including I-2124, which would undermine the state’s new WA Cares Fund long-term care program. The Legislature is evaluating bills that could impact the ballot initiative if they pass, such as HB 2467 and SB 6072.  Learn more at We Care for WA Cares.