The bill aims to enhance coverage for the diagnosis and treatment of obesity under health plans in Washington State. It mandates that, starting January 1, 2026, health carriers must provide coverage for various obesity treatments, including intensive health behavioral and lifestyle treatment, metabolic and bariatric surgery, and FDA-approved obesity medications. The bill specifies that coverage criteria for these medications cannot be more restrictive than FDA-approved indications and that the treatment for obesity should not be treated differently from other medical conditions regarding deductibles and copayments. Additionally, it allows health carriers to apply utilization management to determine medical necessity, provided that the process aligns with how other conditions are assessed.

Furthermore, the bill requires the state authority to apply for federal matching funds by November 1, 2025, to support the coverage of obesity treatment services through managed care organizations. Similar to the provisions for health carriers, the coverage under this section includes intensive health behavioral and lifestyle treatment, metabolic and bariatric surgery, and FDA-approved obesity medications, with the same stipulations regarding coverage criteria and utilization management. The bill reinforces the importance of evidence-based interventions and aligns with current clinical standards of care for obesity treatment.