Bill
SB 5242
Prohibits cost-sharing for abortion in health plans issued or renewed after Jan 1, 2024; enrollees pay no co-pays, deductibles, or coinsurance for abortion services.
Status
- Enacted by the 2023 Legislature; Governor signed April 27, 2023 (chapter 194, 2023 Laws).
- Filed as effective July 23, 2023.
- The bill’s prohibition on cost‑sharing applies to health plans issued or renewed on or after January 1, 2024.
Purpose
- To remove out‑of‑pocket cost barriers (co‑pays, coinsurance, deductibles, etc.) for abortion care by prohibiting health carriers from imposing cost‑sharing for abortion services covered under health plans.
Key provisions
- Amends RCW 48.43.073 to add that for health plans (including student health plans) issued or renewed on or after January 1, 2024, a health carrier may not impose cost‑sharing for abortion of a pregnancy.
- Adds a new section to chapter 41.05 RCW to apply the same prohibition to health plans offered to public employees and their covered dependents issued or renewed on or after January 1, 2024.
- For plans offered as a qualifying high‑deductible health plan for a health savings account (HSA), carriers may set any required cost‑sharing only at the minimum level needed to preserve the enrollee’s ability to claim tax‑favored HSA contributions and withdrawals under IRS rules.
- Retains prior elements of RCW 48.43.073 that require plans that cover maternity care to also provide substantially equivalent coverage to permit abortions, and that plans need not cover abortions that would be unlawful under state law.
- Includes federal‑compliance carveouts: the law does not apply to multistate plans that do not provide abortion coverage (42 U.S.C. §18054(a)(6)), and the prohibition is inapplicable to the minimum extent necessary if application would make the State noncompliant with federal requirements tied to federal funds.
Who is affected
- Health carriers, employers offering group health plans, student health plan administrators, and public employer health plans in Washington.
- Enrollees (individuals covered by those plans) who obtain abortion services—those services, if covered by the plan, cannot require cost‑sharing once the plan is issued/renewed on/after Jan 1, 2024.
- HSA‑eligible enrollees are affected by the special rule preserving HSA tax status.
Implementation and fiscal notes
- No appropriation attached; fiscal note available.
- Effective date for the statute: 90 days after adjournment of the session in which passed (filed as effective July 23, 2023). The operative prohibition targets plan issuances/renewals beginning January 1, 2024.
Public testimony highlights
- Supporters emphasized reducing financial barriers and delays in accessing abortion care (citing average out‑of‑pocket costs and higher costs for later procedures).
- Opponents raised moral objections and concerns about shifting costs onto taxpayers and insured populations.
Relevant legal references
- Amends RCW 48.43.073; adds a section to chapter 41.05 RCW.
Compiled from official sources — confirm details with the bill’s official record.
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