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2019 Senate Bill 5526: Increasing the availability of quality, affordable health coverage in the individual market
Introduced by Sen. David Frockt (Seattle) (D) on January 23, 2019
  Official Text and Analysis.
Referred to the Senate Health & Long-Term Care Committee on January 23, 2019
Substitute offered in the Senate on February 19, 2019
Requires the Washington Health Benefit Exchange to develop standardized health plans.
Referred to the Senate Ways & Means Committee on February 19, 2019
Referred to the Senate Rules Committee on March 9, 2019
Amendment offered by Sen. David Frockt (Seattle) (D) on March 13, 2019
Removes the phase-out of nonstandardized plans offered on the Health Benefit Exchange (Exchange) and instead allows nonstandardized plans to be offered on the Exchange without limitation. (2) Requires the Exchange and the Office of the Insurance Commissioner to analyze the impact to Exchange consumers of offering only standard plans beginning in 2025. Requires that the actuarial value of nonstandardized silver health plans offered on the Exchange be no greater than the actuarial value of the standardized silver plan with the lowest actuarial value. (3) Allows, instead of requires, a qualified health plan offered pursuant to a Health Care Authority (HCA) contract to use a managed care model. Requires a qualified health plan offered pursuant to a HCA contract to: (a) meet additional participation requirements to reduce barriers to maintaining and improving health and align to state agency value-based purchasing; and (b) employ utilization review processes that meet national accreditation standards, align with HCA-published criteria, and are focused on care that has high variation, high cost, or low evidence of clinical effectiveness. Removes the request for qualifications process in which the HCA must contract with all health carriers that meet the minimum qualifications. Instead, requires the HCA, after consulting with the Exchange, to selectively contract with a health carrier or carriers to offer a qualified health plan or plans that offer the optimal combination of choice, affordability, quality, and service. Directs HCA to consider the rates, utilization management policies, pharmaceutical costs, and other factors proposed by the carrier or carriers, with the goal of negotiating for plans that reduce premiums below the average premiums in Washington during plan year 2019. (4) Removes the requirement that the contracted qualified health plans reimburse providers and facilities at a rate equal to the Medicare rate. (5) Directs HCA to negotiate premium rates, with the goal of reducing premiums below the average premiums of the same metal tier in Washington during plan year 2019. (6) Requires the Insurance Commissioner to submit an annual report to the Legislature on the number of health plans available per county in the individual market.
The amendment passed by voice vote in the Senate on March 13, 2019
Amendment offered by Sen. Randi Becker (Eatonville) (R) on March 13, 2019
Removes the provisions related to standard benefit design, establishing a qualified health plan procured by the Health Care Authority, and establishing a premium assistance program; (2) Directs the Office of the Insurance Commissioner to apply to the federal government for a 1332 waiver to improve health insurance affordability for Washingtonians.
The amendment failed by voice vote in the Senate on March 13, 2019
Amendment offered by Sen. Randi Becker (Eatonville) (R) on March 13, 2019
Removes the provisions related to standard benefit design, establishing a qualified health plan procured by the Health Care Authority, and establishing a premium assistance program. (2) Requires, to the extent permitted by federal law, for eligibility to purchase an association health plan to be extended to all individuals.
The amendment failed by voice vote in the Senate on March 13, 2019
Amendment offered by Sen. Steve O'Ban (Pierce County) (R) on March 13, 2019
Directs the Insurance Commissioner, instead of the Health Benefit Exchange, to develop and update standardized benefit health plan designs.
The amendment failed by voice vote in the Senate on March 13, 2019
Amendment offered by Sen. Steve O'Ban (Pierce County) (R) on March 13, 2019
Directs the Insurance Commissioner to annually review the standardized plan designs and provide written comments to the exchange and the chairs of the Senate and House of Representatives health care committees.
The amendment passed by voice vote in the Senate on March 13, 2019
Received in the House on March 15, 2019
Referred to the House Health Care & Wellness Committee on March 15, 2019
Referred to the House Appropriations Committee on April 3, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on April 10, 2019
Allows an individual to purchase individual market coverage across county lines within the same geographic rating area.
The amendment failed by voice vote in the House on April 10, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on April 10, 2019
Lowers the modified adjusted gross income of individuals for whom the Exchange must develop a premium assistance plan from 500% of the federal poverty level to 300% of the federal poverty level.
The amendment failed by voice vote in the House on April 10, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on April 10, 2019
Creates a business and occupations tax exemption for amounts received by a health care provider for services performed on patients covered by a Health Care Authority-contracted qualified health plan, including reimbursement from the qualified health plan and any amounts collected from the patient as part of his or her cost sharing obligation.
The amendment passed by voice vote in the House on April 10, 2019
Amendment offered by Rep. Michelle Caldier (Port Orchard) (R) on April 10, 2019
Requires a qualified health plan offered under Health Care Authority contract to reimburse services at 135% of Medicare rates if they are performed by a provider regulated under the Uniform Disciplinary Act who is not employed by a hospital or by an entity affiliated with a hospital.
The amendment passed by voice vote in the House on April 10, 2019
Amendment offered by Rep. Joe Schmick (Colfax) (R) on April 10, 2019
Requires the Insurance Commissioner, instead of the Exchange, to develop standardized qualified health plans.
The amendment failed by voice vote in the House on April 10, 2019
Received in the House on April 27, 2019
Received in the Senate on April 27, 2019
Signed by Gov. Jay Inslee on May 13, 2019

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