ENGROSSED SUBSTITUTE HOUSE BILL 2361
State of Washington 68th Legislature 2024 Regular Session
By House Health Care & Wellness (originally sponsored by
Representatives Riccelli, Macri, Nance, Reed, Simmons, and Ormsby)
READ FIRST TIME 01/31/24.
1 AN ACT Relating to phasing in the requirement that only
2 standardized health plans may be offered on the health benefit
3 exchange; amending RCW 43.71.095; adding a new section to chapter
4 43.71 RCW; and providing an expiration date.
5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
6 Sec. 1. RCW 43.71.095 and 2021 c 246 s 7 are each amended to
7 read as follows:
8 (1) The exchange, in consultation with the commissioner, the
9 authority, an independent actuary, and other stakeholders, must
10 establish up to three standardized health plans for each of the
11 bronze, silver, and gold levels.
12 (a) The standardized health plans must be designed to reduce
13 deductibles, make more services available before the deductible,
14 provide predictable cost sharing, maximize subsidies, limit adverse
15 premium impacts, reduce barriers to maintaining and improving health,
16 and encourage choice based on value, while limiting increases in
17 health plan premium rates.
18 (b) The exchange may update the standardized health plans
19 annually.
20 (c) The exchange must provide a notice and public comment period
21 before finalizing each year's standardized health plans.
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1 (d) The exchange must provide written notice of the standardized
2 health plans to licensed health carriers by January 31st before the
3 year in which the health plans are to be offered on the exchange. The
4 exchange may make modifications to the standardized plans after
5 January 31st to comply with changes to state or federal law or
6 regulations.
7 (2)(a) Beginning January 1, 2021, any health carrier offering a
8 qualified health plan on the exchange must offer the silver and gold
9 standardized health plans established under this section on the
10 exchange in each county where the carrier offers a qualified health
11 plan. If a health carrier offers a bronze health plan on the
12 exchange, it must offer the bronze standardized health plans
13 established under this section on the exchange in each county where
14 the carrier offers a qualified health plan.
15 (b)(i) Until December 31, ((2022, a health carrier offering a
16 standardized health plan under this section may also offer
17 nonstandardized health plans on the exchange. Beginning January 1,
18 2023,)) 2025, a health carrier offering a standardized health plan
19 under this section may also offer up to two nonstandardized gold
20 health plans, two nonstandardized bronze health plans, one
21 nonstandardized silver health plan, one nonstandardized platinum
22 health plan, and one nonstandardized catastrophic health plan in each
23 county where the carrier offers a qualified health plan.
24 (ii) ((The exchange, in consultation with the office of the
25 insurance commissioner, shall analyze the impact to exchange
26 consumers of offering only standard plans beginning in 2025 and
27 submit a report to the appropriate committees of the legislature by
28 December 1, 2023. The report must include an analysis of how plan
29 choice and affordability will be impacted for exchange consumers
30 across the state, including an analysis of offering a bronze
31 standardized high deductible health plan compatible with a health
32 savings account, and a gold standardized health plan closer in
33 actuarial value to the silver standardized health plan.)) Beginning
34 January 1, 2026:
35 (A) A health carrier offering a standardized health plan under
36 this section may also offer one nonstandardized gold health plan, one
37 nonstandardized bronze health plan, one nonstandardized platinum
38 health plan, and one nonstandardized catastrophic health plan in each
39 county where the carrier offers a qualified health plan; and
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1 (B) Nonstandardized silver plans may not be offered on the
2 exchange.
3 (iii) The actuarial value of nonstandardized silver health plans
4 offered on the exchange may not be less than the actuarial value of
5 the standardized silver health plan with the lowest actuarial value.
6 (c) A health carrier offering a standardized health plan on the
7 exchange under this section must continue to meet all requirements
8 for qualified health plan certification under RCW 43.71.065
9 including, but not limited to, requirements relating to rate review
10 and network adequacy.
11 (3) The exchange must annually review whether standardized health
12 plans continue to maximize federal funding, ensure plan choice for
13 individuals with health conditions, and respond to market conditions
14 using the consultation process under subsection (1) of this section.
15 NEW SECTION. Sec. 2. A new section is added to chapter 43.71
16 RCW to read as follows:
17 (1) The exchange shall evaluate the effects on exchange consumers
18 and health carriers of prohibiting nonstandardized silver plans on
19 the exchange and reexamine whether moving toward a standardized
20 market could provide a better customer experience with minimal market
21 disruption. If the exchange finds that moving toward a standardized
22 market remains advisable, it shall recommend a plan to the
23 legislature on how to standardize the exchange market using a phased
24 approach. The plan must include any additional authority the exchange
25 requires to develop standardized plans at other actuarial value
26 levels. The exchange shall report its findings and recommendations to
27 the appropriate committees of the legislature no later than December
28 1, 2028.
29 (2) This section expires January 1, 2029.
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Statutes affected: Original Bill: 43.71.095
Substitute Bill: 43.71.095
Engrossed Substitute: 43.71.095