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Evergreen Ledger

SHB 2720

Introduced

House

Behavioral health services

Increasing access and resources for behavioral health emergency services providers by imposing a covered lives assessment on specific health plans.

This status may be delayed. See Action History below for the latest updates.

How does a bill become law?
  1. Introduced: The bill is filed and assigned a number.
  2. Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
  3. Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
  4. Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
  5. Governor: The Governor reviews the bill and decides whether to sign or veto it.
  6. Signed: The bill has been signed into law.
Introduced: February 8, 2026
Last Action: February 14, 2026
Status: H 2nd Reading
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AI Analysis

This analysis was generated by AI and may contain errors. It is not legal advice. Always refer to the official bill text for authoritative information.
People & CommunitiesPeople-leaningCorporate & Wealthy Interests

This bill establishes a dedicated funding stream for behavioral health crisis services in Washington by requiring private health plans to pay an annual assessment per enrollee, starting in 2027. The funds will support community-based crisis care for people not on Medicaid, helping reduce reliance on emergency departments and jails. It also adjusts how state investment earnings are distributed to include this new account.

  • Creates a new Behavioral Health Emergency Services Account in the state treasury, funded by an annual assessment on private health plans.
  • Imposes an annual per-member-per-month assessment of $0.58 in 2027 (adjusted biennially) on health carriers, self-funded employer plans, and Taft-Hartley trusts covering Washington residents.
  • Requires the Insurance Commissioner to collect assessments, enforce reporting, and impose penalties (including 150% fines and liens) for late or nonpayment.
  • Limits funding to behavioral health crisis services—such as mobile crisis teams, crisis stabilization units, and 23-hour crisis centers—provided to people not enrolled in Medicaid.
  • Reenacts and amends multiple versions of RCW 43.84.092 to include the new account in the state’s investment earnings distribution formula.
  • Establishes a sunset clause with varying expiration dates for different sections between July 1, 2028 and January 1, 2029, contingent on the expiration of related Medicaid expansion laws.

Who is affected

  • Private health insurers and plan administrators — Private health insurers (health carriers, self-funded employer plans, Taft-Hartley trusts) must pay an annual assessment based on the number of Washington residents they cover, starting in 2027.
  • Behavioral health crisis service providers — Behavioral health crisis providers—such as mobile crisis teams, crisis stabilization units, and crisis relief centers—will receive state funding to support services for people not covered by Medicaid.
  • Residents without Medicaid coverage needing behavioral health crisis care — People experiencing behavioral health crises who are not on Medicaid will gain access to community-based crisis services instead of relying on emergency departments or law enforcement.
  • State government and taxpayers — The state treasury will reallocate investment earnings to include the new Behavioral Health Emergency Services Account, affecting how interest from state investments is distributed across state funds.
Effective: January 1, 2027Fiscal impact: The bill creates a new annual assessment of $0.58 per covered life in 2027, increasing every two years (up to 10% per adjustment) based on inflation and population changes. This is expected to generate tens of millions of dollars annually to fund behavioral health crisis services. The bill also modifies how state investment earnings are distributed, directing a portion to the new account.
Model: Intel/Qwen3-Coder-Next-int4-AutoRoundGenerated: Mar 19, 2026 at 8:15 PM

Pro/Con Analysis

Stronger case for benefits

Potential Benefits (5)

  • The bill creates a dedicated funding stream for community-based crisis services (mobile crisis teams, crisis stabilization units, 23-hour centers) for people *not* on Medicaid—reducing reliance on emergency departments and law enforcement, which currently bear the burden of behavioral health crises and often result in incarceration or hospitalization.

    Public SafetyPeopleRef: Sec. 4(2)(a); Sec. 1(1)(c)

  • By funding crisis services for non-Medicaid enrollees, the bill directly expands access to timely, appropriate care for a large underserved group—approximately 1.1 million Washingtonians who are insured but not on Medicaid and currently face significant barriers to crisis care coverage.

    HealthcarePeopleRef: Sec. 4(2)(a); Sec. 1(1)(b), (d)

  • The bill addresses a documented cost-shifting problem: emergency department visits for primary mental health diagnoses cost significantly more than community-based crisis care, and the assessment model aligns financial responsibility with the payer—reducing uncompensated care burdens on hospitals and public facilities.

    HealthcarePeopleRef: Sec. 1(1)(a); Sec. 4(2)(a)

  • The bill supports crisis service providers—many of which are community-based nonprofits or small businesses—by guaranteeing state funding for services they already provide, stabilizing their operations and enabling expansion into new service areas, especially where state capital funding has built facilities but no sustainable service model exists.

    Business & EmploymentPeopleRef: Sec. 4(2)(a); Sec. 6

  • The bill establishes a dedicated, ring-fenced account (Behavioral Health Emergency Services Account) funded by a broad-based assessment on private health plans—not general fund taxes—ensuring that revenue is dedicated solely to crisis services and protected from budget cuts or reallocation.

    FinancialPeopleRef: Sec. 4(1); Sec. 7–12 (reenactment/amendment of RCW 43.84.092)
Potential Concerns (5)

  • The bill imposes a new per-member-per-month assessment ($0.58 in 2027, biennially adjusted) on private health plans—including self-funded employer plans and Taft-Hartley trusts—which increases administrative and compliance costs for employers and insurers, especially small and mid-sized businesses that lack dedicated billing infrastructure.

    Business & EmploymentRef: Sec. 3(7); Sec. 4(2)(a)

  • The bill explicitly excludes individuals enrolled in Medicaid (including Medicaid managed care) from receiving services funded by this account, meaning low-income residents who are already most vulnerable to gaps in crisis care remain excluded—despite the bill’s stated goal of expanding access to “all regardless of insurance status.”

    HealthcarePeopleRef: Sec. 4(3)(a); Sec. 3(2)

  • The bill allows expenditures only for services administered through Behavioral Health Administrative Services Organizations (BHASOs), which may limit flexibility for rural or under-resourced counties without established BHASO infrastructure, potentially delaying or preventing service expansion in those areas.

    Local GovernmentLean peopleRef: Sec. 4(2)(b); Sec. 3(5)(b)

  • The bill includes multiple contingent and staggered sunset dates tied to the expiration of RCW 74.76.040 (the Medicaid expansion law), creating uncertainty about long-term funding stability and potentially disrupting multi-year planning by crisis service providers.

    Public SafetyLean peopleRef: Sec. 14–15 (sunset provisions)

  • The bill imposes a 150% civil penalty for late or nonpayment of assessments and authorizes liens and legal collection—increasing legal and financial risk for covered entities, especially smaller plans with limited cash flow or compliance resources.

    Business & EmploymentRef: Sec. 3(5)(b); Sec. 3(7)

Who Is Most Affected

Private health insurers and plan administratorsNegative Impact

Private health plans (including self-funded employer plans and Taft-Hartley trusts) will bear the direct cost of the assessment, increasing administrative and financial burden—especially for smaller plans without existing crisis billing infrastructure. While the cost is modest per member ($0.58 in 2027), it is a new regulatory and financial obligation.

Behavioral health crisis service providersPositive Impact

Crisis service providers—especially those operating mobile crisis teams, crisis stabilization units, and 23-hour centers—will gain stable, predictable state funding to expand services to non-Medicaid populations, reducing reliance on emergency systems and improving service sustainability.

Residents without Medicaid coverage needing behavioral health crisis carePositive Impact

Residents without Medicaid coverage who experience behavioral health crises will gain access to community-based crisis care instead of being funneled into emergency departments or jails. However, those on Medicaid remain excluded, limiting the reach of the benefit to the most vulnerable low-income populations.

State government and taxpayersMixed Impact

The state treasury gains a new dedicated revenue stream, but the reallocation of investment earnings to the new account slightly reduces the proportion of earnings available to other state funds (e.g., transportation, education), though the impact is likely small given the relatively modest size of the account. The state also gains improved alignment with mental health parity requirements.

Local governments and public safety agenciesMixed Impact

Local governments (counties, cities) may benefit from reduced demand on law enforcement and emergency medical services for behavioral health crises, but may face challenges if their region lacks a BHASO or if service rollout is delayed due to sunset provisions or administrative delays.