HB 1627
In CommitteeHouse
Health plans/annual services
Providing enrollees flexibility in obtaining services covered annually or on a multiyear basis.
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 requires health insurers to let enrollees get certain annual or multiyear services (like mammograms or dental cleanings) up to one month earlier than the standard interval—without charging more for those services. It applies to all health, dental, and vision plans starting in 2026, and updates how state employee health plans are regulated.
- For annual services (e.g., mammograms, dental cleanings), health plans must allow enrollees to receive the service at least one month before the 12-month mark without increasing cost-sharing.
- For biennial or longer-interval services (e.g., certain eye exams or screenings), plans must allow services at least one month before the scheduled interval (e.g., before 24 months) with the same cost-sharing as if done on schedule.
- Applies to all health plans, including dental-only and vision-only plans, issued or renewed on or after January 1, 2026.
- Requires health carriers to apply the same copays, coinsurance, and deductibles regardless of whether the service is done just before or after the standard interval.
- Expands coverage rules under RCW 48.43.500 et al. to include the new flexibility requirement, and incorporates this new rule into the state employee health plan statutes (RCW 41.05.017).
Who is affected
- State employees, retirees, and dependents covered under state health plans — Employees and retirees enrolled in state-sponsored health, dental, or vision plans will gain more flexibility in timing of annual or multiyear services (e.g., mammograms, dental cleanings) without facing higher out-of-pocket costs.
- Individual and small-group health plan enrollees — Individuals and families purchasing health, dental, or vision insurance through the individual or small-group markets will be able to receive covered preventive or routine services slightly earlier than once-per-year or once-per-two-years without paying higher copays or coinsurance.
- Health insurance carriers — Health insurance companies (carriers) that issue or renew plans in Washington must adjust their coverage rules to allow earlier timing of certain services while maintaining the same cost-sharing as if the service were done at the standard interval.
- Healthcare providers — Healthcare providers (e.g., dentists, optometrists, physicians) may see changes in scheduling patterns for routine services, as patients may request appointments slightly earlier than previously allowed.
Pro/Con Analysis
Potential Benefits (5)
Enrollees gain flexibility to receive covered preventive or routine services (e.g., mammograms, dental cleanings) up to one month earlier without increased cost-sharing, improving access and potentially enabling earlier detection of health issues.
HealthcarePeopleRef: Sec. 1While the bill may slightly increase short-term service utilization, the fiscal impact is expected to be minimal and potentially offset by long-term savings from earlier preventive care—benefiting enrollees through improved health outcomes rather than direct cost savings.
HealthcarePeopleRef: Fiscal Impact sectionThe requirement to maintain identical cost-sharing for services performed slightly earlier may reduce administrative burden for insurers and providers, but does not directly reduce premiums or out-of-pocket costs for enrollees.
HealthcareLean peopleRef: Sec. 1Incorporation of the new rule into state employee health plans ensures uniform application across public-sector coverage, but does not extend benefits to those not enrolled in state plans (e.g., some public employees covered under separate systems).
HealthcareLean peopleRef: Sec. 2The one-month flexibility window is narrow and applies only to services already covered at standard intervals—so it does not expand coverage to new services or populations, limiting overall impact on access.
HealthcareLean peopleRef: Sec. 1
Potential Concerns (5)
Enrollees gain flexibility to receive covered preventive or routine services (e.g., mammograms, dental cleanings) up to one month earlier without increased cost-sharing, improving access and potentially enabling earlier detection of health issues.
HealthcarePeopleRef: Sec. 1, Sec. 2While the bill may slightly increase short-term service utilization, the fiscal impact is expected to be minimal and potentially offset by long-term savings from earlier preventive care—benefiting enrollees through improved health outcomes rather than direct cost savings.
HealthcarePeopleRef: Fiscal Impact sectionThe requirement to maintain identical cost-sharing for services performed slightly earlier may reduce administrative burden for insurers and providers, but does not directly reduce premiums or out-of-pocket costs for enrollees.
HealthcareLean peopleRef: Sec. 1Incorporation of the new rule into state employee health plans ensures uniform application across public-sector coverage, but does not extend benefits to those not enrolled in state plans (e.g., some public employees covered under separate systems).
HealthcareLean peopleRef: Sec. 2The one-month flexibility window is narrow and applies only to services already covered at standard intervals—so it does not expand coverage to new services or populations, limiting overall impact on access.
HealthcareLean peopleRef: Sec. 1
Who Is Most Affected
State employees, retirees, and dependents gain predictable, no-cost flexibility to schedule preventive services slightly earlier, improving continuity of care without added burden.
Individual and small-group enrollees benefit from improved scheduling flexibility and protection against unexpected cost increases for routine services—especially helpful for those with high-deductible plans.
Health insurers face minimal operational adjustments but must update systems to track timing windows and ensure consistent cost-sharing—costs likely absorbed without major financial impact.
Providers may see modest shifts in scheduling patterns (e.g., more patients requesting appointments just before 12-month marks), but no significant change in revenue or workflow is expected.
Low- and middle-income households relying on preventive care may benefit most from improved access, but the narrow time window limits broader affordability impact.