HB 1603
In CommitteeHouse
Medicare supp. coverage
Requiring guaranteed issue of medicare supplemental coverage to an individual who voluntarily disenrolls from a medicare advantage plan and enrolls in medicare parts A and B.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill ensures that Washington residents who leave their Medicare Advantage plan to join Original Medicare (Parts A and B) — or who lose other qualifying coverage — can buy a Medicare Supplement (Medigap) policy without being denied or charged more due to health issues. It expands guaranteed-issue rights and tightens enrollment timelines and insurer obligations.
- Requires insurance companies to offer Medicare Supplement (Medigap) policies to people who voluntarily leave their Medicare Advantage plan and enroll in Original Medicare (Parts A and B), without requiring medical underwriting.
- Guarantees access to Medigap coverage for people who lose employer-sponsored or other supplemental coverage (e.g., due to plan termination), regardless of health status.
- Sets strict time limits (63 days) for applying for a Medigap policy after losing qualifying coverage — known as a 'guaranteed issue' period.
- Prohibits insurers from denying coverage, charging higher prices, or imposing preexisting condition exclusions for eligible applicants.
- Requires Medicare Advantage plans and other insurers to notify people when their coverage ends that they may qualify for guaranteed-issue Medigap coverage.
- Clarifies that people who enroll in a Medicare Advantage plan or PACE program within 12 months of first becoming eligible for Medicare can later get a Medigap policy if they disenroll.
Who is affected
- Voluntarily disenrolled Medicare Advantage members — People who leave their Medicare Advantage plan voluntarily to join Original Medicare (Parts A and B) during a special enrollment period, and who want to buy a Medicare Supplement (Medigap) policy without being denied or charged higher premiums due to health issues.
- Medicare Supplement insurance issuers — Insurance companies that sell Medicare Supplement (Medigap) policies in Washington State, which must now offer coverage to certain enrollees without medical underwriting and follow strict timing rules for enrollment.
- Newly eligible Medicare beneficiaries who switch from Medicare Advantage — Seniors age 65+ who recently enrolled in a Medicare Advantage plan or PACE program and decide to switch back to Original Medicare within 12 months — they gain guaranteed access to a Medigap policy.
- Individuals losing employer-based Medicare supplemental coverage — People who lose their employer-sponsored supplemental health coverage (e.g., due to job loss or plan termination) and need to buy a Medigap policy to fill gaps in Medicare coverage.
- Medicare Part D enrollees seeking to restore prior Medigap drug coverage — People enrolled in Medicare Part D (prescription drug plans) who previously had a Medigap plan that included drug coverage and now want to re-enroll in a Medigap plan without health questions.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (4)
Guarantees access to Medigap coverage without medical underwriting for individuals who lose employer-sponsored or other supplemental coverage (e.g., due to job loss, plan termination) — a critical safety net for older, sicker, or lower-income beneficiaries who may be unable to afford coverage elsewhere. This prevents coverage gaps and protects against denial or price gouging during transitions, directly improving continuity of care and financial protection for vulnerable populations.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(1), (2), (3)(a), (d)Ensures that individuals who voluntarily disenroll from Medicare Advantage (e.g., due to dissatisfaction with network, benefits, or quality) can obtain Medigap coverage without health questions — a right previously unavailable in Washington. This empowers beneficiaries to switch back to Original Medicare with confidence, improving consumer choice and accountability for Advantage plans, especially for those with chronic conditions or complex care needs who find Advantage networks restrictive.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(3)(b)(v), (6)(d)Mandates timely, standardized notices to enrollees about their guaranteed-issue rights and deadlines (e.g., 63-day window), reducing information asymmetry and helping beneficiaries avoid lapses in coverage. This is especially beneficial for low-income, less-tech-savvy, or non-English-speaking seniors who may otherwise miss critical enrollment windows and face coverage gaps or penalties.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(5), (6)(a)-(f)Allows individuals who enroll in Medicare Advantage or PACE within 12 months of first becoming eligible and later disenroll to obtain Medigap coverage — a group that includes younger, healthier new seniors who may have chosen Advantage for perceived savings but later find it unsuitable. While this benefits individual choice, it also helps those who discover they have unmet health needs or financial burdens under Advantage, preventing them from being locked out of Medigap due to age or health status.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(3)(f), (e)
Potential Concerns (4)
Mandates guaranteed-issue Medigap coverage for individuals who voluntarily disenroll from Medicare Advantage and enroll in Original Medicare — a population that includes many healthier, higher-income seniors who chose Advantage plans for lower premiums or extra benefits. This provision may increase premiums for Medigap policies overall, as insurers must accept higher-risk applicants within the 63-day window, and may lead to adverse selection if healthier beneficiaries disproportionately switch back to Original Medicare and then buy Medigap, leaving insurers with sicker risk pools. The 63-day enrollment window and notice requirements also increase administrative burden on insurers, potentially passed on to consumers in higher premiums.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(3)(b)(v), (5), (6)(d)Expands guaranteed-issue rights to individuals who enroll in Medicare Advantage or PACE within 12 months of first becoming eligible and later disenroll — a group that includes many younger, healthier new Medicare beneficiaries. While this helps those who regret their choice, it may encourage risk selection by insurers: plans may market Advantage more aggressively to healthier beneficiaries, knowing they can exit and re-enter Medigap later without underwriting. This could destabilize Advantage risk pools and increase premiums for those who remain.
HealthcarePeopleRef: Sec. 1, RCW 48.66.055(3)(e), (f)Imposes new notice and timing obligations on insurers and Medicare Advantage plans to inform enrollees of guaranteed-issue rights within strict windows (e.g., 10 days of disenrollment, contemporaneous termination notice). While consumer-facing, these requirements increase compliance and operational costs for insurers and plans — particularly smaller or regional issuers — which may reduce competition or lead to consolidation, ultimately limiting consumer choice and potentially raising prices.
Business & EmploymentPeopleRef: Sec. 1, RCW 48.66.055(5), (6)Requires insurers to offer Medigap plans without outpatient prescription drug coverage to individuals who previously had drug coverage — effectively forcing a downgrade in benefits for those switching back to Original Medicare. This may increase out-of-pocket costs for beneficiaries who relied on Medigap Part D, especially those with high drug needs, unless they separately enroll in a costly Part D plan. The bill does not require insurers to offer a seamless replacement, creating a gap in coverage.
HealthcareLean peopleRef: Sec. 1, RCW 48.66.055(4)(a)(ii)(B)
Who Is Most Affected
Low- and moderate-income Medicare beneficiaries with chronic conditions or complex health needs who lose employer-sponsored or other supplemental coverage. They gain critical access to Medigap without medical underwriting, reducing coverage gaps and out-of-pocket risk — especially if they cannot afford private insurance post-termination.
Older (70+) Medicare beneficiaries dissatisfied with Medicare Advantage networks or quality may now switch back to Original Medicare and buy Medigap without health questions — improving access and peace of mind. However, healthier beneficiaries may disproportionately use this option, potentially increasing Medigap premiums over time.
Insurers face new obligations to issue policies without underwriting, increasing administrative costs and potential adverse selection. While the 63-day window limits risk, the requirement to cover preexisting conditions (no exclusions) and provide standardized notices raises compliance burdens — especially for smaller regional insurers.
Medicare Advantage plans must now notify enrollees of disenrollment rights and may see increased churn as beneficiaries opt out and re-enroll in Medigap. This could reduce their market share and increase administrative costs, but may also incentivize them to improve plan quality to retain members.
Healthcare providers may see improved continuity of care for patients who gain Medigap coverage, reducing billing complications and denied claims. However, if more beneficiaries switch to Original Medicare, providers may face increased administrative complexity due to separate Part A/B billing vs. Advantage’s capitated model.