Bill > HB1326

This bill mandates comprehensive obesity treatment coverage for health plans and state medical assistance programs, beginning January 1, 2026. The legislation requires health carriers and managed care organizations to provide coverage for obesity as a chronic disease, including three key treatment categories: intensive health behavioral and lifestyle treatment, metabolic and bariatric surgery, and FDA-approved obesity medications. The bill specifies that coverage for obesity treatments must be equivalent to coverage for other medical conditions, with the same deductible, copayment, and coinsurance considerations. Health carriers can still apply standard utilization management processes to determine medical necessity, but these must be applied consistently with how they assess other medical conditions. The bill defines specific terms like "intensive health behavior and lifestyle treatment" as evidence-based interventions supporting healthy weight management, which can be delivered in-person or via telemedicine. For the Medicaid program, the state is required to seek federal authorization by November 1, 2025, to receive matching funds for these obesity treatment services. The goal is to ensure comprehensive, standardized, and accessible obesity treatment across different health insurance platforms in Washington state.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=1326&Year=2025&Initiative=false