The bill establishes the Medicaid Access Program in Washington State, designed to improve access to Medicaid services through a system of assessments on health carriers and Medicaid managed care organizations. It creates a new Medicaid Access Program account to collect funds from these assessments, which will be allocated for increasing professional service rates for Medicaid providers, making payments to healthcare providers, and covering administrative costs. The bill specifies assessment rates, payment schedules, and conditions for collection, requiring approval from the Centers for Medicare and Medicaid Services. Additionally, it includes provisions for rule adoption, civil and criminal liability protections for good faith actions, and mandates a study on the impact of rate increases on Medicaid access.

Moreover, the bill amends existing laws regarding the treasury income account, ensuring that the "medicaid access program account" is included among accounts eligible for earnings distribution. It introduces new sections in Title 74 and Title 48 RCW, clarifying that the act's provisions are not severable and that prior assessments and payments remain valid if any part of the act is rendered ineffective. The act is deemed necessary for public health and safety, taking effect immediately, and will expire if federal approval is not obtained by January 1, 2027. Specific sections are set to expire on July 1, 2028, and the act will become null and void if funding is not provided by June 30, 2025, ensuring the implementation of health care initiatives is contingent upon federal approval and adequate funding.