The bill seeks to improve access and affordability of health insurance in Washington state by amending existing laws and introducing new certification criteria for health plans. It empowers the Washington health benefit exchange to adopt additional criteria beyond the 19 established under the Affordable Care Act, focusing on specific market conditions that affect access and affordability. The exchange is required to collaborate with the insurance commissioner to ensure compliance with state and federal laws, while also considering factors such as cost-sharing, covered benefits, and provider networks. Stakeholder engagement is emphasized, with mandates for public hearings and a structured timeline for adopting these new criteria.

Additionally, the bill introduces new reporting requirements for the health benefit exchange, including data on enrollee percentages by county and the number of waivers for market factor certification criteria. The initial report is due in 2030, covering data from 2028 and 2029. It also establishes confidentiality for information submitted by health carriers for certification and mandates collaboration between the exchange, the commissioner, and health carriers in counties with limited carrier options to ensure at least two carriers provide health plans. This aims to foster competition and improve access to healthcare services in underserved areas.

Statutes affected:
Original bill: 43.71.065
Substitute bill: 43.71.020, 43.71.065
Engrossed substitute: 43.71.020, 43.71.065