Postpartum coverage

AN ACT Relating to postpartum coverage; and amending RCW 1
74.09.830. 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:3
Sec. 1. RCW 74.09.830 and 2024 c 213 s 4 are each amended to 4
read as follows: 5
(1) The authority shall extend health care coverage from 60 days 6
postpartum to ((one year )) six months postpartum for pregnant or 7
postpartum persons who, on or after the expiration date of the 8
federal public health emergency declaration related to COVID-19, are 9
receiving postpartum coverage provided under this chapter.10
(2) By June 1, 2022, the authority must: 11
(a) Provide health care coverage to postpartum persons who reside 12
in Washington state, have countable income equal to or below 193 13
percent of the federal poverty level, and are not otherwise eligible 14
under Title XIX or Title XXI of the federal social security act; and15
(b) Ensure all persons approved for pregnancy or postpartum 16
coverage at any time are continuously eligible for postpartum 17
coverage for ((12)) six months after the pregnancy ends regardless of 18
whether they experience a change in income during the period of 19
eligibility. 20
H-1523.2
HOUSE BILL 2041
State of Washington 69th Legislature 2025 Regular Session
By Representatives Macri, Gregerson, and Parshley
Read first time 03/20/25. Referred to Committee on Appropriations.
p. 1 HB 2041
(3) By November 1, 2024, the income standards for a postpartum 1
person eligible for Washington apple health pregnancy or postpartum 2
coverage shall have countable income equal to or below 210 percent of 3
the federal poverty level. 4
(4) Health care coverage under this section must be provided 5
during the ((12-month)) six-month period beginning on the last day of 6
the pregnancy. 7
(5) The authority shall not provide health care coverage under 8
this section to individuals who are eligible to receive health care 9
coverage under Title XIX or Title XXI of the federal social security 10
act. Health care coverage for these individuals shall be provided by 11
a program that is funded by Title XIX or Title XXI of the federal 12
social security act. Further, the authority shall make every effort 13
to expedite and complete eligibility determinations for individuals 14
who are presumptively eligible to receive health care coverage under 15
Title XIX or Title XXI of the federal social security act to ensure 16
the state is receiving the maximum federal match. This includes, but 17
is not limited to, working with the managed care organizations to 18
provide continuous outreach in various modalities until the 19
individual's eligibility determination is completed. Beginning 20
January 1, 2022, the authority must submit quarterly reports to the 21
caseload forecast work group on the number of individuals who are 22
presumptively eligible to receive health care coverage under Title 23
XIX or Title XXI of the federal social security act but are awaiting 24
for the authority to complete eligibility determination, the number 25
of individuals who were presumptively eligible but are now receiving 26
health care coverage with the maximum federal match under Title XIX 27
or Title XXI of the federal social security act, and outreach 28
activities including the work with managed care organizations.29
(6) To ensure continuity of care and maximize the efficiency of 30
the program, the amount and scope of health care services provided to 31
individuals under this section must be the same as that provided to 32
pregnant and postpartum persons under medical assistance, as defined 33
in RCW 74.09.520. 34
(7) In administering this program, the authority must seek any 35
available federal financial participation under the medical 36
assistance program, as codified at Title XIX of the federal social 37
security act, the state children's health insurance program, as 38
codified at Title XXI of the federal social security act, and any 39
other federal funding sources that are now available or may become 40
p. 2 HB 2041
available. This includes, but is not limited to, ensuring the state 1
is receiving the maximum federal match for individuals who are 2
presumptively eligible to receive health care coverage under Title 3
XIX or Title XXI of the federal social security act by expediting 4
completion of the individual's eligibility determination.5
(8) Working with stakeholder and community organizations and the 6
Washington health benefit exchange, the authority must establish a 7
comprehensive community education and outreach campaign to facilitate 8
applications for and enrollment in the program or into a more 9
appropriate program where the state receives maximum federal match. 10
Subject to the availability of amounts appropriated for this specific 11
purpose, the education and outreach campaign must provide culturally 12
and linguistically accessible information to facilitate participation 13
in the program, including but not limited to enrollment procedures, 14
program services, and benefit utilization. 15
(9) Beginning January 1, 2022, the managed care organizations 16
contracted with the authority to provide postpartum coverage must 17
annually report to the legislature on their work to improve maternal 18
health for enrollees, including but not limited to postpartum 19
services offered to enrollees, the percentage of enrollees utilizing 20
each postpartum service offered, outreach activities to engage 21
enrollees in available postpartum services, and efforts to collect 22
eligibility information for the authority to ensure the enrollee is 23
in the most appropriate program for the state to receive the maximum 24
federal match. 25
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p. 3 HB 2041