E2SSB 6128

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.


Synopsis as Enacted

Brief Description: Extending coverage during the postpartum period.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Randall, Darneille, Dhingra, Frockt, Hasegawa, Hunt, Kuderer, Lovelett, Salomon, Stanford, Van De Wege, Nguyen and Wilson, C.).

Senate Committee on Health & Long Term Care

Senate Committee on Ways & Means

House Committee on Appropriations

Background: The Health Care Authority (HCA) administers Washington's Apple Health program providing medical assistance primarily through Medicaid. Apple Health offers eligible families, children under age 19, low-income adults, certain disabled individuals, and pregnant women a complete medical benefits package.

Currently, Apple Health provides coverage to pregnant individuals with countable income at or below 193 percent of the federal poverty level (FPL), regardless of citizenship or immigration status. Once an individual is enrolled, they are covered regardless of any change in income through the end of the month, following the 60th day after the pregnancy end date. For example, if a pregnancy ends June 10th, health care coverage continues through August 31st.

Individuals receive this post-partum coverage regardless of how the pregnancy ends. Individuals who apply for coverage after the baby’s birth may not receive postpartum coverage, but they may qualify for help paying costs related to the baby’s birth if they submit the application within three months after the month in which the child was born.

In 2016, the Legislature established The Maternal Mortality Review Panel to review and identify factors associated with maternal deaths occurring in the state, and to make recommendations to improve healthcare for women. The panel's 2019 report to the Legislature included a recommendation to ensure funding and access to postpartum care and support through the first year after the end of pregnancy.

Summary: By January 1, 2021, HCA must submit a waiver request to the Centers for Medicare and Medicaid Services for the state to receive federal match for extending postpartum coverage to 12 months postpartum to individuals with countable income at or below 193 percent of FPL and report to the Legislature on the status of the waiver request. Once the state becomes eligible to receive federal financial participation, HCA must extend health care coverage to 12 months postpartum for individuals who reside in Washington State, have countable income at or below 193 percent FPL, and are not otherwise eligible for existing Apple Health programs.

Votes on Final Passage:







(House amended)




(Senate concurred)