Bill > SB5075

This bill requires health insurance plans to eliminate cost-sharing (such as copays, deductibles, and coinsurance) for certain prenatal and postnatal care services. Specifically, for nongrandfathered health plans issued or renewed after January 1, 2026, insurers cannot charge patients for in-network prenatal services like office visits, lab tests, ultrasounds, screening tests, and prenatal vitamins. Starting January 1, 2027, this will also apply to prescription drugs related to pregnancy. The prenatal services period begins when the first pregnancy-related claim is received and continues until delivery, and the postnatal services period extends 12 weeks after delivery, with additional coverage for pregnancy complications up to one year postpartum. For health savings account-compatible plans, cost-sharing can be set at the minimum level necessary to maintain tax-exempt account status. The bill applies to various types of health plans, including those created by insuring entities and plans not typically subject to insurance regulations. The Office of the Insurance Commissioner is authorized to adopt rules to implement these requirements, with the goal of reducing financial barriers to comprehensive maternity care.

Budget and Finance, Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5075&Year=2025&Initiative=false