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, eliminating means testing, and aims to reduce disparities in health care access, particularly for marginalized communities. A board of trustees will govern the trust, ensuring diverse representation and input on health services and budget decisions. Key provisions include the establishment of a comprehensive benefits package, protections against discrimination, and the inclusion of nonresidents under certain conditions.

Additionally, the bill introduces significant changes to employer spending requirements for health care expenditures, effective January 1, 2028, and establishes a new Health Options Program to provide uninsured residents with access to essential health benefits. It mandates that employers make quarterly health care expenditures for employees starting January 1, 2029, with specific assessment rates based on business size. The legislation also implements a long-term capital gains tax, effective January 1, 2026, targeting capital gains income exceeding $200,000 to fund the Washington Health Trust. Overall, the bill aims to enhance health care access and funding while ensuring accountability among employers through structured contributions and compliance measures.