HB 1754
In CommitteeHouse
Medicare suppl./guaranteed
Requiring medicare supplemental insurance to be offered on a guaranteed issue basis during an open enrollment period.
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 insurance companies to sell Medicare Supplement (Medigap) policies to eligible people during specific open enrollment periods without asking about health history or charging higher prices. It also limits or eliminates preexisting condition waiting periods for qualified applicants.
- Insurance companies cannot deny or charge higher prices for Medicare Supplement (Medigap) policies based on health status, claims history, or medical conditions during two key times: (1) a 6-month window starting when a person turns 65 and enrolls in Medicare Part B, and (2) annual open enrollment periods for Medicare Part B or Medicare Advantage.
- During those windows, insurers must offer all available Medigap plans to eligible applicants regardless of age.
- If an applicant has had continuous creditable health coverage for at least 3 months, insurers cannot impose any preexisting condition waiting periods.
- If an applicant has had less than 3 months of creditable coverage, insurers must reduce any preexisting condition waiting period by the amount of prior creditable coverage they’ve had.
- The law applies to all Medicare Supplement policies and certificates currently offered in Washington State.
Who is affected
- People turning 65 and enrolling in Medicare Part B — People turning 65 and enrolling in Medicare Part B gain the right to buy Medicare Supplement (Medigap) insurance without being denied or charged more due to health issues, during a 6-month window starting when they turn 65 and join Part B.
- Existing Medicare beneficiaries (Part B or Medicare Advantage) — Current Medicare Part B or Medicare Advantage enrollees can apply for Medicare Supplement insurance during their annual open enrollment period without being denied or charged higher premiums based on health status.
- Insurance companies selling Medicare Supplement policies — Insurance companies must offer all available Medigap plans to eligible applicants during open enrollment periods and cannot use preexisting condition exclusions (or must reduce them based on prior creditable coverage).
- Applicants with prior creditable health coverage — People who have had continuous creditable health coverage (e.g., employer or union coverage, other Medicare coverage) for at least 3 months before applying will avoid preexisting condition waiting periods entirely.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Guarantees access to Medigap coverage for all Medicare-eligible Washingtonians aged 65+ during open enrollment—regardless of health status—eliminating a major source of insurance denial and financial risk for seniors with chronic conditions or prior illnesses.
HealthcarePeopleRef: Sec. 1(1)(a)(i); Sec. 1(2), (3)Prevents preexisting condition exclusions for applicants with ≥3 months of creditable coverage and reduces waiting periods for those with less—protecting seniors who switch plans or lose prior coverage from losing Medigap access during transitions.
HealthcarePeopleRef: Sec. 1(1)(a)(ii); Sec. 1(2), (3)Strengthens consumer autonomy by ensuring age- and health-neutral access to supplemental coverage, reducing age-based discrimination and empowering seniors to choose plans based on need rather than medical history.
Rights & LibertiesPeopleRef: Sec. 1(1)(a)(i); Sec. 1(1)(b)Reduces out-of-pocket healthcare costs for seniors with preexisting conditions by eliminating costly Medigap denials or surcharges—many of whom would otherwise face high-cost private plans or gaps in coverage leading to avoidable hospitalizations.
FinancialPeopleRef: Sec. 1(1)(a)(i); Sec. 1(2), (3)Improves continuity of care and reduces emergency department utilization by ensuring timely access to supplemental insurance during health transitions—especially important for low-income seniors who delay care due to cost concerns.
Public SafetyPeopleRef: Sec. 1(1)(a)(ii); Sec. 1(2), (3)
Potential Concerns (3)
Reduces insurers’ ability to price risk accurately, potentially increasing premiums for healthy enrollees over time as insurers adjust for adverse selection—though the guaranteed-issue windows are time-limited, the annual open enrollment provision may encourage delayed enrollment, worsening risk pools in subsequent years.
HealthcarePeopleRef: Sec. 1(1)(a)(i), (ii); Sec. 1(2), (3)Insurance companies may face increased administrative and compliance costs to implement new underwriting rules and track creditable coverage, which could reduce profitability for Medigap-specific plans—though many insurers already comply with federal Medicare Supplement rules, Washington’s annual open enrollment adds complexity beyond current federal requirements.
Business & EmploymentLean peopleRef: Sec. 1(1)(a)(ii); Sec. 2 (effective date: 2027)The Washington Office of Insurance Regulation will need to increase oversight and enforcement capacity to ensure compliance with the new guaranteed-issue and age-neutral requirements, potentially diverting resources from other consumer protection priorities.
Local GovernmentLean peopleRef: Sec. 1(1)(a)(i); Sec. 1(2)
Who Is Most Affected
Seniors turning 65 and enrolling in Medicare Part B gain guaranteed access to Medigap coverage without health screening—this is especially critical for those with disabilities, chronic illnesses, or limited prior coverage. They benefit significantly, with reduced financial and health risks.
Existing Medicare beneficiaries gain annual opportunities to switch Medigap plans without health underwriting—helping those whose health declined or whose plans were discontinued. However, those in good health may see modest premium increases over time due to risk-pool changes.
Insurers must absorb higher administrative costs and reduced underwriting flexibility, especially during the annual open enrollment window. While federal law already mandates guaranteed issue at age 65+ for 6 months, Washington’s annual provision adds complexity—smaller insurers may be disproportionately affected.
Applicants with ≥3 months of creditable coverage (e.g., from employer plans or prior Medicare) avoid preexisting condition waiting periods entirely—this group is disproportionately higher-income or recently employed. Those with <3 months benefit less but still gain partial relief.
Low-income seniors and people with disabilities—who are more likely to have gaps in coverage or rely on Medicaid—benefit most from guaranteed access, as they face the highest risk of Medigap denial or unaffordable premiums under prior practices.