HB 2658
In CommitteeHouse
Mental health coverage
Concerning the truth in mental health coverage act.
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 creates a public reporting system to improve transparency and accountability in how health insurance plans cover mental health and substance use services. It requires insurers to share detailed, standardized data on access, reimbursement, and network coverage, which the state will publish online to help consumers and regulators identify gaps and ensure fair access.
- Requires health insurance carriers to annually submit detailed data on mental health and substance use disorder coverage and access—including utilization reviews, out-of-network use, in-network reimbursement rates, provider network size, and appeal outcomes—to the Office of the Insurance Commissioner by July 1 each year, starting in 2027.
- Mandates that the Commissioner adopt standardized reporting templates and definitions to ensure consistent, comparable data across insurers and over time.
- Requires carriers to report data separately for youth and adults, in-person and telehealth services, and by facility and provider type—including whether providers are owned or affiliated with the insurer.
- Requires the Commissioner to publish all raw data on a public website within three months of receipt and maintain an interactive dashboard updated by September 1 each year, allowing public comparison of coverage and access across insurers.
- Requires carriers to retain all supporting data for three years and submit a signed certification from a senior officer confirming data accuracy and completeness.
Who is affected
- Washington residents seeking mental health or substance use disorder care — Residents of Washington State who need mental health or substance use disorder services, especially youth and their families, may face improved access due to increased transparency and accountability in insurance network coverage and provider reimbursement.
- Health insurance carriers operating in Washington — Health insurance companies (carriers) must begin collecting, reporting, and certifying detailed data on behavioral health coverage and access starting in 2027.
- Washington State Office of the Insurance Commissioner — State government staff in the Office of the Insurance Commissioner will gain new responsibilities to develop reporting standards, collect and verify data, and maintain a public dashboard.
- Researchers, mental health advocates, and employers — Researchers, advocates, employers, and the public will gain access to standardized, comparable data on mental health and substance use coverage across insurers.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
The creation of a public, interactive dashboard with standardized, comparable metrics on mental health and substance use coverage will empower consumers, families, advocates, and researchers to identify and challenge inequities in network access, reimbursement, and utilization practices — especially for youth and telehealth services, where gaps are severe.
HealthcarePeopleRef: Sec. 2(5)(a), (c), (d); Sec. 2(6)(a)-(c)Mandated reporting of utilization review outcomes, psychiatric collaborative care metrics, and appeal outcomes will expose systemic delays and denials that currently restrict access — enabling regulators and advocates to push for corrective action and policy reforms.
HealthcarePeopleRef: Sec. 2(3)(i), (vii), (viii)Reporting provider ownership/affiliation, in-network reimbursement rates indexed to Medicare, and network admission timelines will help identify whether insurers favor their own affiliated providers or delay network onboarding — practices that suppress competition and limit consumer choice.
HealthcarePeopleRef: Sec. 2(1)(c), (3)(iii), (3)(vi)Standardized reporting templates and definitions — informed by federal, state, and stakeholder best practices — will ensure data comparability over time and across insurers, enabling trend analysis and evidence-based oversight that was previously impossible due to inconsistent reporting.
HealthcarePeopleRef: Sec. 2(2), Sec. 2(4)The requirement for senior officers to certify data accuracy and completeness creates accountability and deters underreporting or misclassification — increasing trust in the data and enabling more effective enforcement of parity laws.
HealthcarePeopleRef: Sec. 2(7)
Potential Concerns (3)
Insurers must invest in data collection, validation, and certification infrastructure to comply with annual reporting requirements, including hiring or reassigning staff and upgrading IT systems to meet standardized templates and certification requirements.
Business & EmploymentRef: Sec. 2(7)Insurers must retain all supporting data for three years, increasing storage, compliance, and legal risk management costs — though these are likely absorbed within existing IT and compliance budgets by large carriers.
Business & EmploymentRef: Sec. 2(9)Data is explicitly declared non-confidential and non-proprietary, potentially exposing competitive pricing and network strategies to public scrutiny — a risk more acute for smaller insurers with less market power.
Business & EmploymentRef: Sec. 2(5)(d)
Who Is Most Affected
Residents seeking mental health or SUD care — especially youth, low-income individuals, and those in rural areas — will benefit most, as transparent data will expose network gaps and reimbursement disparities, enabling advocacy, informed plan selection, and pressure on insurers to expand access. This addresses the 7.1–16.7× higher out-of-network use for behavioral health vs. medical services cited in the bill.
Insurers will face increased administrative burden and transparency risk, but large national carriers are well-resourced to comply; smaller regional carriers may struggle more with implementation costs. Competitive pressure may increase as performance becomes public, potentially driving network and pricing reforms.
The Office of the Insurance Commissioner gains new tools to enforce parity laws and monitor market behavior, but must allocate staff and resources to develop, maintain, and verify the dashboard. This strengthens regulatory capacity without requiring new funding, per the fiscal impact estimate.
Researchers, advocates, employers, and community organizations gain access to standardized, comparable data — enabling rigorous analysis, public awareness campaigns, and evidence-based policy proposals. This empowers grassroots and institutional actors to hold insurers accountable.