Creates the Washington access for all trust, which is an agency of state government, for the purpose of providing coverage for a set of health services for all residents.

Abolishes the state health care authority and transfers its powers, duties, and functions to the Washington access for all trust.

Requires state employers to pay an assessment, in quarterly installments, on aggregate gross payroll paid to state residents.

Creates the reserve account, the displaced worker training account, and the benefits account.