Three more Washington health bills we’re watching


Aaron Kunkler


With Washington’s legislative session set to convene on Jan. 10, bills continue to be prefiled, including three additional ones which State of Reform will be watching dealing with surprise medical bills, counselor disclosure, and water fluoridation. 

The first bill, HB 1688, has already garnered bipartisan support with Reps. Eileen Cody and Joe Schmick sponsoring it. It would help protect consumers from charges for out-of-network health care services and align state law with the federal No Surprises Act. It would also address coverage of treatment for emergency conditions. 


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Specifically, the bill would direct the Insurance Commissioner’s office to analyze data on commercial health plan claims to assess impacts on payments to participating and nonparticipating providers and on utilization of out-of-network services on the impacts of the legislation. A report would be due by next December. 

Critically the bill would remove the need to gain approval for emergency treatment. However, hospitals and emergency behavioral health service providers must make a “good faith effort” to notify the patient’s health carrier within 30 minutes of stabilization. If a health carrier requires this notification, then it must make someone available around the clock to receive notification. 

Additionally, if a patient pays a nonparticipating or out-of-network provider or air ambulance service, and the amount exceeds the in-network cost-sharing amount determined by the Public Health Services Act, the provider or facility must refund any amount in excess of the in-network amount to the patient within 30 business days. 

Under the federal No Surprises Act, patients are entitled to similar protections, and the proposed bill would bring Washington in line with the law. 

On behavioral health, SB 5596 would conform disclosure restrictions for mental health counselors, marriage and family therapists, and social workers to requirements outlined in the Uniform Health Care Information Act. It would require providers to provide clients with accurate information about their practice, including the right of clients to refuse treatment, and allow disclosure of medical information as provided under this chapter of state law. 

Finally, the third bill, HB 1684, is designed to increase the number of Washingtonians served by fluoridated water. It would require water systems to include an analysis of the cost to create and run fluoridation when it conducts system planning. It also states that water systems that want to discontinue fluoridation must notify the local health department at least 90 days beforehand, and inform its customers about its intention as well as the negative health impacts of eliminating fluoride. 

Fluoridated tap water leads to a 25% reduction in tooth decay over a lifetime. While roughly 75% of Americans are served by fluoridated water systems, only 56% of Washingtonians are. Inequalities in dental health exist in Washington, where third graders from low-income households suffer tooth decay at twice the rate of children from higher-income households, the bill states. 

Hispanic, American Indian and Alaska Native children have a 50% higher rate of tooth decay than the general population. Fluoridated tap water is one way to improve these disparities, the bill states. 

There are cost benefits as well. The Centers for Disease Control and Prevention estimate a return on investment for ratepayers of $4 for every dollar spent on fluoridation in small communities, and $27 for every dollar spent on fluoridation in large communities. It’s estimated that Washingtonians could save an estimated $32 million in Medicaid and $14 million in state employee benefit programs over 10 years through fluoridation.