Worker health care costs

AN ACT Relating to preserving medical assistance programs by 1
assessing employers for their workers' health care costs paid by the 2
state; amending RCW 74.09.053; adding a new section to chapter 49.60 3
RCW; adding a new chapter to Title 74 RCW; and prescribing penalties.4
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:5
NEW SECTION. Sec. 1. (1) The legislature finds that:6
(a) Recent federal changes to the medicaid program will affect 7
all sectors of Washington's health care system. With reduced federal 8
moneys, there will be pressure for the state to restore funds to 9
maintain critical health services and program eligibility. By seeking 10
reimbursement from employers whose workers are enrolled in medical 11
assistance programs, the state can preserve the coverage and services 12
available to Washingtonians who rely on publicly financed health 13
care; and 14
(b) An important part of a comprehensive approach to providing 15
appropriate health care for all Washington citizens involves 16
participation by employers in providing access to health care 17
services for their workers and their families. While most Washington 18
citizens obtain health care services through their employment or the 19
employment of a family member, some employers with adequate resources 20
fail to offer affordable access to health care services to their 21
H-2417.2
HOUSE BILL 2300
State of Washington 69th Legislature 2026 Regular Session
By Representatives Reeves, Thai, Berry, Santos, Zahn, Thomas, Ormsby,
Macri, Fosse, Hill, and Pollet
Prefiled 01/07/26. Read first time 01/12/26. Referred to Committee
on Health Care & Wellness.
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workers in Washington state. This creates inappropriate competitive 1
advantages for those employers and greatly increases the likelihood 2
that their workers will not have access to affordable health care 3
services or will receive health care services through publicly funded 4
health care programs. 5
(2)(a) It is the intent of the legislature to establish, as part 6
of its comprehensive approach to preserving access to appropriate 7
health care services, a mechanism to reimburse the state for its 8
costs of providing access to appropriate health care services to 9
Washington workers. Employer participation in this comprehensive 10
approach allows the state to improve its financing of public health 11
care programs and prioritize those resources on populations not 12
served through employment. It also reduces the burden on taxpayers 13
and the public health care system, and protects the health, safety, 14
and well-being of all the state's residents. 15
(b) In establishing this program, it is not the intent of the 16
legislature to influence the establishment, content, or 17
administration of employee benefit plans. The legislature is neutral 18
regarding whether employers choose to provide access to affordable 19
health care coverage for their workers or pay an assessment to 20
reimburse the state's costs for health care services for their 21
workers. 22
NEW SECTION. Sec. 2. The definitions in this section apply 23
throughout this chapter unless the context clearly requires 24
otherwise.25
(1) "Assessment value" means an amount equal to the state portion 26
of the per capita cost of providing health benefits under medical 27
assistance programs under chapter 74.09 RCW for a calendar quarter.28
(2) "Authority" means the health care authority.29
(3) "Department" means the department of employment security.30
(4) "Employer" means an "employer" as defined in RCW 49.46.010 31
who employed a total of 500 or more workers at any and all locations 32
in Washington in the completed calendar quarter for which a report is 33
made in section 3 of this act. "Employer" includes a franchisor that 34
has franchisees in Washington state that collectively employ a total 35
of 500 or more workers. "Employer" does not include:36
(a) An employer that makes payments for the purpose of providing 37
or reimbursing the cost of health care services, as defined in RCW 38
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48.43.005, for all of its workers who are enrolled in medical 1
assistance programs under chapter 74.09 RCW; or 2
(b) A seasonal employer. 3
(5) "Seasonal employer" means an employer in an industry, other 4
than the construction industry, that the agencies determine, upon 5
application by the employer: 6
(a) Customarily operates only during regularly recurring periods 7
of 26 weeks or less in any 52 consecutive week period; or8
(b) Customarily employs 50 percent or more of its workers for 9
regularly recurring periods of 26 weeks or less within a period of 52 10
consecutive weeks. 11
(6) "Worker" means any individual subject to the community 12
engagement requirements under 42 U.S.C. Sec. 1396a who is either 13
employed or independently contracted to work 80 or more hours per 14
month for an employer during a given calendar quarter, but does not 15
include: 16
(a) A worker employed by the employer for fewer than 90 days;17
(b) During the first 12 months of employment with the employer, a 18
worker who was employed through the job placement activities of the 19
department of social and health services, the employment security 20
department, or organizations contracting with these agencies to 21
provide job placement services; 22
(c) A worker at a franchisor's franchisees. Such workers are 23
employed by the franchisor; 24
(d) A worker who is receiving disability benefits under the 25
federal old-age, survivors, and disability insurance act;26
(e) The federal government; 27
(f) The state, state institutions, and state agencies; and28
(g) Any unit of local government including, but not limited to, a 29
county, city, town, municipal corporation, quasi-municipal 30
corporation, or political subdivision. 31
NEW SECTION. Sec. 3. (1) The apple health corporate assessment 32
program is established through a partnership between the authority 33
and the department for the purpose of requiring certain employers of 34
medical assistance program enrollees to reimburse the state for the 35
cost of purchasing health care coverage for its workers. Funds 36
received through the program shall be deposited in the apple health 37
corporate assessment account under section 6 of this act.38
(2) Beginning with the calendar quarter ending June 30, 2027:39
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(a) Within 30 days of the completion of a calendar quarter, the 1
authority and department shall jointly determine which workers 2
employed by employers during the immediately preceding calendar 3
quarter are under 65 years old and enrolled in a medical assistance 4
program under chapter 74.09 RCW during the calendar quarter;5
(b) Upon making the determination in (a) of this subsection, the 6
department shall calculate the total amount of the assessment value 7
for each employer. The total amount shall be the assessment value, as 8
established and published by the authority, multiplied by the number 9
of workers employed by the employer who were enrolled in a medical 10
assistance program under chapter 74.09 RCW for any period of time 11
during the calendar quarter; 12
(c) Within 60 days of completion of a calendar quarter, the 13
department shall notify each employer that has workers enrolled in 14
medical assistance programs under chapter 74.09 RCW of the total 15
amount of the assessment value for which the employer is 16
responsible. The department may not disclose the names of workers 17
identified, but shall provide the employer with the number of workers 18
identified as enrolled. The notice shall inform the employer that the 19
employer shall pay the total amount of the assessment value specified 20
in the notice for each worker under age 65 who is enrolled in medical 21
assistance programs under chapter 74.09 RCW. 22
(3) Within 30 days of receiving the notice under subsection 23
(2)(c) of this section, the employer shall pay the full amount of the 24
assessment required under subsection (2)(c) of this section. All 25
payments for a particular quarter must be made within three calendar 26
quarters of the notification from the authority for that calendar 27
quarter. 28
(4) An employer that fails, within the time period required by 29
subsection (3) of this section, to pay the assessment provided for in 30
subsection (2) of this section is subject to: 31
(a) A civil penalty of five percent of the assessment due for the 32
first month or part thereof, 10 percent of the assessment due for the 33
second month or part thereof, and 20 percent of the assessment due 34
for the third month or part thereof; 35
(b) An interest penalty of one percent per month on the 36
assessment due; and 37
(c) The suspension of eligibility for any tax preference under 38
Title 82 or 84 RCW and any state funds for up to five years. The 39
department shall notify the department of revenue and the department 40
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of enterprise services of any employer that has had its eligibility 1
suspended under this subsection. 2
(5)(a) An employer may request a hearing by filing a request with 3
the department within 30 days after the date on which the employer 4
received the notice required in subsection (2)(b) of this 5
section. The hearing must be conducted in accordance with chapter 6
34.05 RCW. 7
(b) If any employer fails to pay an assessment after it has 8
become a final and unappealable order, or after the court has entered 9
final judgment in favor of the department, the department shall refer 10
the matter to the state attorney general, who shall recover the 11
amount assessed, and any penalties and interest, by action in the 12
superior court. In such an action, the validity and appropriateness 13
of the final order imposing the penalty is not subject to review.14
NEW SECTION. Sec. 4. (1) An enrollee or prospective enrollee 15
has a right to be free of interference, coercion, discrimination, or 16
reprisal from an employer for exercising their rights under chapter 17
74.09 RCW. The remedies provided in this section are not exclusive, 18
and an enrollee or prospective enrollee has all other rights and 19
remedies afforded by law.20
(2)(a) An employer may not discriminate in any manner against a 21
worker or job applicant because the person has: 22
(i) Made inquiries about enrollment or the person's rights to 23
enrollment in medical assistance programs under chapter 74.09 RCW or 24
assisted another in regard to rights to such enrollment;25
(ii) Applied for or enrolled in, or communicated an intent to 26
enroll in, medical assistance programs under chapter 74.09 RCW, 27
caused any proceeding related to such enrollment to be instituted, or 28
testified in any proceeding so commenced; or 29
(iii) Cooperated with the authority with respect to becoming 30
enrolled in medical assistance programs under chapter 74.09 RCW or 31
for purposes of section 3 of this act. 32
(b) Any discrimination or attempt to discriminate against a 33
worker within 90 days after notification of the employer under 34
section 3 of this act that the employer has workers enrolled in 35
medical assistance programs under chapter 74.09 RCW establishes a 36
rebuttable presumption that such action was in violation of this 37
section. 38
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(3) Persons who believe that they have been discriminated against 1
in violation of this section: 2
(a) May, within six months after the alleged act of 3
discrimination, file a complaint with the human rights commission 4
alleging discrimination. Upon receipt of such complaint, the human 5
rights commission shall cause an investigation to be made as the 6
commission deems appropriate. Within 60 days after the receipt of a 7
complaint filed under this section, the human rights commission shall 8
notify the complainant of the determination. If, after such 9
investigation, the human rights commission determines that this 10
section has been violated, the commission shall bring an action in 11
the superior court of the county in which the violation is alleged to 12
have occurred. If the human rights commission determines that this 13
section has not been violated, the worker may institute the action on 14
the worker's own behalf as provided in (b) of this subsection, but 15
this subsection does not require a complainant to file a complaint 16
with the human rights commission before pursuing remedies under (b) 17
of this subsection; and 18
(b) Has a civil cause of action for damages against the employer.19
(4) In any action brought under this section, the court shall 20
award a prevailing plaintiff costs, including expert witness costs, 21
and reasonable attorneys' fees and actual damages, or statutory 22
damages of $5,000, whichever is greater, to be awarded to the 23
aggrieved worker or job applicant. The court has jurisdiction, for 24
cause shown, to restrain violations of this section and to order all 25
appropriate relief including reinstatement of a worker, or hiring of 26
a job applicant, with back pay. 27
(5) For the purposes of this section, "discrimination" includes, 28
but is not limited to: 29
(a) Refusal to employ, reemploy, or promote; 30
(b) Discharge from employment or demotion or suspension;31
(c) Reduction in hours of work, compensation, or other adverse 32
changes in the conditions of employment; and 33
(d) Involuntary transfer to another position or other duties.34
NEW SECTION. Sec. 5. The authority and the department each have 35
distinct responsibilities, as well as collaborative functions, in the 36
implementation and administration of the apple health corporate 37
assessment program. The authority and the department shall 38
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collaborate as necessary to realize program efficiencies in the 1
operation of the program. 2
(1) The authority shall: 3
(a) Determine the assessment value each calendar quarter and 4
publish the assessment value; and 5
(b) Adopt rules necessary to implement this chapter.6
(2) The department shall: 7
(a) Notify each employer of the amount of its assessment 8
obligation each quarter; 9
(b) Calculate the amount of the assessment value for each 10
employer; 11
(c) Collect the assessment amount and any applicable civil 12
penalty or interest penalty from each employer; 13
(d) Deposit assessments, civil penalties, and interest penalties 14
collected under this chapter into the apple health corporate 15
assessment account under section 6 of this act; and16
(e) Perform investigations to determine the compliance of the 17
payment of assessments by employers and impose civil penalties and 18
interest penalties on employers that are noncompliant with the 19
requirements of this chapter. 20
(3) The authority and the department shall collaborate to:21
(a) Adopt a procedure to determine which workers are enrolled in 22
a medical assistance program under chapter 74.09 RCW during a given 23
calendar year; and 24
(b) Adopt data-sharing agreements as necessary to perform their 25
functions under this act. 26
NEW SECTION. Sec. 6. The apple health corporate assessment 27
account is created in the state treasury. All receipts from the 28
payment of assessments, civil penalties, and interest penalties by 29
employers must be deposited into the account. Moneys in the account 30
may be spent only after appropriation. Expenditures from the account 31
may only be used for reimbursing the authority for the cost of 32
purchasing health care services, such as physical health services, 33
behavioral health services, and long-term services and supports, 34
including home and community-based services, for enrollees in medical 35
assistance programs under chapter 74.09 RCW or other health safety 36
net programs.37
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NEW SECTION. Sec. 7. A new section is added to chapter 49.60 1
RCW to read as follows: 2
Any person claiming to be aggrieved by a violation of section 4 3
of this act may file a complaint with the commission. The commission 4
shall promptly investigate and take other appropriate action as 5
provided in section 4 of this act. 6
Sec. 8. RCW 74.09.053 and 2023 c 51 s 34 are each amended to 7
read as follows: 8
(1) ((Beginning in November 2012, the department of social and 9
health services, in coordination with the )) The health care 10
authority((,)) shall, by November 15th of each year , report to the 11
legislature: 12
(a) The number of medical assistance recipients who: (i) Upon 13
enrollment or recertification had reported being employed, and 14
beginning with the 2008 report, the month and year they reported 15
being hired; or (ii) upon enrollment or recertification had reported 16
being the dependent of someone who was employed, and beginning with 17
the 2008 report, the month and year they reported the employed person 18
was hired. For recipients identified under (a)(i) and (ii) of this 19
subsection, the ((department)) authority shall report the basis for 20
their medical assistance eligibility, including but not limited to 21
family medical coverage, transitional medical assistance, children's 22
medical coverage, aged coverage, or coverage for individuals with 23
disabilities; member months; and the total cost to the state for 24
these recipients, expressed as general fund -state and general 25
fund-federal dollars. Beginning with the 2027 report, the report must 26
include a list of the employers that are subject to the payment of an 27
assessment under section 3 (3) of this act and which of those 28
employers are subject to the penalties in section 3 (4) of this act 29
for noncompliance with section 3 (3) of this act. The information 30
shall be reported by employer size for employers having more than 31
((fifty)) 50 employees as recipients or with dependents as 32
recipients. This information shall be provided for the preceding 33
January and June of that year. 34
(b) The following aggregated information: (i) The number of 35
employees who are recipients or with dependents as recipients by 36
private and governmental employers; (ii) the number of employees who 37
are recipients or with dependents as recipients by employer size for 38
employers with ((fifty)) 50 or fewer employees, ((fifty-one)) 51 to 39
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((one hundred )) 100 employees, ((one hundred one )) 101 to ((one 1
thousand)) 1,000 employees, ((one thousand one )) 1,001 to ((five 2
thousand)) 5,000 employees and more than ((five thousand )) 5,000 3
employees; and (iii) the number of employees who are recipients or 4
with dependents as recipients by industry type. 5
(2) For each aggregated classification, the report will include 6
the number of hours worked, the number of department of social and 7
health services covered lives, and the total cost to the state for 8
these recipients. This information shall be for each quarter of the 9
preceding year. 10
NEW SECTION. Sec. 9. If any part of this act is found to be in 11
conflict with federal requirements that are a prescribed condition to 12
the allocation of federal funds to the state, the conflicting part of 13
this act is inoperative solely to the extent of the conflict and with 14
respect to the agencies directly affected, and this finding does not 15
affect the operation of the remainder of this act in its application 16
to the agencies concerned. Rules adopted under this act must meet 17
federal requirements that are a necessary condition to the receipt of 18
federal funds by the state.19
NEW SECTION. Sec. 10. If any provision of this act or its 20
application to any person or circumstance is held invalid, the 21
remainder of the act or the application of the provision to other 22
persons or circumstances is not affected.23
NEW SECTION. Sec. 11. This act may be known and cited as the 24
apple health corporate assessment act.25
NEW SECTION. Sec. 12. Sections 1 through 6, 9, and 11 of this 26
act constitute a new chapter in Title 74 RCW.27
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