WSR 25-15-010
PROPOSED RULES
HEALTH CARE AUTHORITY
[Filed July 3, 2025, 9:33 a.m.]
Original Notice.
Preproposal statement of inquiry was filed as WSR 25-11-010.
Title of Rule and Other Identifying Information: WAC 182-532-510 Family planning only program—Eligibility.
Hearing Location(s): On August 26, 2025, at 10:00 a.m. The health care authority (HCA) holds public hearings virtually without a physical meeting place. To attend the virtual public hearing, you must register in advance at https://us02web.zoom.us/webinar/register/WN_8Nt1PNm-Tf-IeJnRVSYXPg.
If the link above opens with an error message, please try using a different browser. After registering, you will receive a confirmation email containing information about joining the public hearing.
Date of Intended Adoption: Not sooner than August 27, 2025.
Submit Written Comments to: HCA Rules Coordinator, P.O. Box 42716, Olympia, WA 98504-2716, email arc@hca.wa.gov, fax 360-586-9727, beginning July 4, 2025, 8:00 a.m., by August 26, 2025, 11:59 p.m.
Assistance for Persons with Disabilities: Contact HCA rules coordinator, phone 360-725-1349, fax 360-586-9727, telecommunication relay service 711, email arc@hca.wa.gov, by August 8, 2025.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: HCA is amending WAC 182-532-510 to expand eligibility for family planning only coverage to people age 26 and younger who are confidentially seeking those services.
Reasons Supporting Proposal: See purpose.
Statutory Authority for Adoption: RCW 41.05.021 and 41.05.160.
Statute Being Implemented: RCW 41.05.021 and 41.05.160.
Rule is not necessitated by federal law, federal or state court decision.
Name of Proponent: HCA, governmental.
Name of Agency Personnel Responsible for Drafting: Brian Jensen, P.O. Box 42716, Olympia, WA 98504-2716, 360-725-0815; Implementation and Enforcement: Sheldon Prante, P.O. Box 42722, Olympia, WA 98504-2722, 360-725-0752.
A school district fiscal impact statement is not required under RCW 28A.305.135.
A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 does not apply to HCA rules unless requested by the joint administrative rules review committee or applied voluntarily.
This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal:
Is exempt under RCW 19.85.025(4).
Explanation of exemptions: The proposed rules pertain to client program eligibility and do not impose costs on businesses.
Scope of exemption for rule proposal:
Is fully exempt.
July 3, 2025
Wendy Barcus
Rules Coordinator
RDS-6379.2
AMENDATORY SECTION(Amending WSR 25-06-057, filed 2/28/25, effective 3/31/25)
WAC 182-532-510Family planning only program—Eligibility.
For the purposes of this section, "full-scope coverage" means coverage under either the categorically needy (CN) program, the broadest, most comprehensive scope of health care services covered or the alternative benefits plan (ABP), the same scope of care as CN, applicable to the apple health for adults program.
(1) To be eligible for family planning only services, as defined in WAC 182-532-001, a client must:
(a) Provide a valid Social Security number (SSN) or proof of application to receive an SSN, be exempt from the requirement to provide an SSN as provided in WAC 182-503-0515, or meet good cause criteria listed in WAC 182-503-0515(2);
(b) Be a Washington state resident, as described under WAC 182-503-0520;
(c) Have an income at or below 260 percent of the federal poverty level, as described under WAC 182-505-0100;
(d) Need family planning services; and
(e) Have been denied apple health coverage within the last 30 days, unless the applicant:
(i) Has made an informed choice to not apply for full-scope coverage as described in WAC 182-500-0035 and 182-501-0060, including family planning;
(ii) Is age ((18))26 or younger and seeking services in confidence;
(iii) Is a domestic violence victim who is seeking services in confidence; or
(iv) Has an income of 150 percent to 260 percent of the federal poverty level, as described in WAC 182-505-0100.
(2) A client is not eligible for family planning only medical if the client is:
(a) Pregnant;
(b) Sterilized;
(c) Covered under another apple health program that includes family planning services; or
(d) Covered by concurrent creditable coverage, as defined in RCW 48.66.020, unless they meet criteria in subsection (1)(e)(ii) or (iii) of this section.
(3) The agency does not limit the number of times a client may reapply for coverage.