S-3982.1

SENATE BILL 6258

BySenators Cleveland, Robinson, and Nobles

AN ACT Relating to phasing in the requirement that only standardized health plans may be offered on the health benefit exchange; amending RCW 43.71.095; and adding a new section to chapter 43.71 RCW.

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

Sec. 1. RCW 43.71.095 and 2021 c 246 s 7 are each amended to read as follows:

(1) The exchange, in consultation with the commissioner, the authority, an independent actuary, and other stakeholders, must establish up to three standardized health plans for each of the bronze, silver, and gold levels. Beginning in 2027, the exchange may establish additional standardized plans at other actuarial value levels, including catastrophic and platinum.

(a) The standardized health plans must be designed to reduce deductibles, make more services available before the deductible, provide predictable cost sharing, maximize subsidies, limit adverse premium impacts, reduce barriers to maintaining and improving health, and encourage choice based on value, while limiting increases in health plan premium rates.

(b) The exchange may update the standardized health plans annually.

(c) The exchange must provide a notice and public comment period before finalizing each year's standardized health plans.

(d) The exchange must provide written notice of the standardized health plans to licensed health carriers by January 31st before the year in which the health plans are to be offered on the exchange. The exchange may make modifications to the standardized plans after January 31st to comply with changes to state or federal law or regulations.

(2)(a) Beginning January 1, 2021, any health carrier offering a qualified health plan on the exchange must offer the silver and gold standardized health plans established under this section on the exchange in each county where the carrier offers a qualified health plan. If a health carrier offers a bronze health plan on the exchange, it must offer the bronze standardized health plans established under this section on the exchange in each county where the carrier offers a qualified health plan.

(b)(i) Until ((December 31, 2022, a health carrier offering a standardized health plan under this section may also offer nonstandardized health plans on the exchange. Beginning January 1, 2023,))January 1, 2026, a health carrier offering a standardized health plan under this section may also offer up to two nonstandardized gold health plans, two nonstandardized bronze health plans, one nonstandardized silver health plan, one nonstandardized platinum health plan, and one nonstandardized catastrophic health plan in each county where the carrier offers a qualified health plan.

(ii) ((The exchange, in consultation with the office of the insurance commissioner, shall analyze the impact to exchange consumers of offering only standard plans beginning in 2025 and submit a report to the appropriate committees of the legislature by December 1, 2023. The report must include an analysis of how plan choice and affordability will be impacted for exchange consumers across the state, including an analysis of offering a bronze standardized high deductible health plan compatible with a health savings account, and a gold standardized health plan closer in actuarial value to the silver standardized health plan.))Beginning January 1, 2026, and until January 1, 2027, a health carrier offering a standardized health plan under this section may also offer up to two nonstandardized gold health plans, two nonstandardized bronze health plans, one nonstandardized platinum health plan, and one nonstandardized catastrophic health plan in each county where the carrier offers a qualified health plan.

(((iii)))(iv) The actuarial value of nonstandardized silver health plans offered on the exchange may not be less than the actuarial value of the standardized silver health plan with the lowest actuarial value.

(c) A health carrier offering a standardized health plan on the exchange under this section must continue to meet all requirements for qualified health plan certification under RCW 43.71.065 including, but not limited to, requirements relating to rate review and network adequacy.

NEW SECTION.  Sec. 2. A new section is added to chapter 43.71 RCW to read as follows:

(1) For 2027, the exchange must develop at least one standardized gold plan at the lower range of allowable actuarial value, at least one standardized high deductible health plan that is compatible with a health savings account, and at least one standardized catastrophic health plan. The exchange may also establish additional standardized health plans at other actuarial value levels, including platinum and catastrophic. When developing standardized health plans under this section, the exchange must use the consultation process established in RCW 43.71.095(1). Any standardized health plans developed under this section must meet the requirements of RCW 43.71.095(1) (a) through (d).

(2) Beginning January 1, 2027, a health carrier may elect to offer standardized health plans developed under this section only if the health carrier is also offering standardized health plans in full compliance with RCW 43.71.095.

(3) The exchange may designate a standardized health plan developed under this section for purposes of RCW 43.71.095.

(4) The exchange, using the consultation process established in RCW 43.71.095(1), may evaluate and adjust standardized health plans developed under this section to respond to changes in consumers' choice of health plans offered on the exchange and market conditions.

--- END ---