AN ACT Relating to expanding access to health care for all state residents with apple health on the health benefit exchange; and adding a new section to chapter 74.09 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1.  A new section is added to chapter 74.09 RCW to read as follows:

(1) The health care authority, in consultation with the health benefit exchange, must seek any necessary waivers of federal law to allow apple health to be offered as an option for individuals who are otherwise ineligible for medicaid to purchase coverage through the health benefit exchange. The apple health public option must offer a comprehensive benefit package with the essential health benefits, including reproductive care, and an actuarial value of the silver benefit package with the related cost sharing.

(2) The apple health option is intended to provide an additional health insurance option for state residents purchasing individual coverage, to ensure statewide access for all residents. To the extent allowed by federal law, the plan should seek to maximize federal funding with access to advance premium tax credits and cost-sharing subsidies that may be available. It is the intent that apple health be available alongside the exchange qualified health plans with financial assistance within the same income standards, and the option to purchase coverage without financial assistance above the income requirements set for premium tax credits.

(3) The authority must procure the apple health option to be offered by one or more managed care plans. To the extent allowed by federal law the authority must explore options to combine the risk pool for the new apple health public option with apple health. The authority and the exchange must advise the legislature if the procurement of the public option necessitates any statutory changes, such as the definition of a qualified health plan. The authority must share quarterly progress reports with the legislature on the status of discussions for waivers, program development, and financing estimates.

(4) To ensure a robust provider network the authority must increase provider reimbursement rates above the medicaid managed care rates for all providers participating in apple health and the apple health public option on the exchange.

(5) The director, in consultation with the governor and the joint committee on health care oversight, must explore options to form regional risk pools or regional purchasing options with Oregon and California.

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