The proposed bill seeks to create the Washington Health Trust, a comprehensive public health financing system that guarantees medical coverage for all residents of Washington State. This coverage will encompass essential health benefits, including primary care, dental, vision, and prescription drug services, without imposing premiums, deductibles, or copayments. The bill emphasizes universal eligibility and equitable access to healthcare, particularly for marginalized communities, while prohibiting discrimination based on race, gender identity, or socioeconomic status. To oversee the trust, a Board of Trustees with 17 members will be established, responsible for managing operations, creating a benefits package, and negotiating reimbursement rates with healthcare providers.

Additionally, the bill introduces significant changes to employer health care expenditure requirements, effective January 1, 2028, by only counting irrevocable expenditures towards the employer spending requirement. It mandates that employers provide written summaries of health care expenditures to employees and outlines the establishment of a new Health Options Program for uninsured residents. The bill also implements a new excise tax on long-term capital gains, effective January 1, 2026, to fund the Washington Health Trust, with specific rates and exemptions detailed. Overall, the legislation aims to enhance healthcare access and ensure that employers fulfill their financial obligations while establishing a sustainable funding mechanism for the health trust.