Text of WA HB 1612 (2020)

AN ACT Relating to eliminating barriers to reproductive health 1 care for all; amending RCW 48.43.072; adding new sections to chapter 2 74.09 RCW; creating new sections; and providing an effective date. 3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: 4 NEW SECTION. Sec. 1. The legislature finds and declares: 5 (1) It is the public policy of this state to provide the maximum 6 access to reproductive health care and reproductive health care 7 coverage for all people in Washington state. 8 (2) In 2018, the legislature passed Substitute Senate Bill No. 9 6219. Along with reproductive health care coverage requirements, the 10 bill mandated a literature review of barriers to reproductive health 11 care. As documented by the report submitted to the legislature on 12 January 1, 2019, young people, immigrants, people living in rural 13 communities, transgender and gender nonconforming people, and people 14 of color face significant barriers to getting the reproductive health 15 care they need. 16 (3) Immigrants in Washington state are a vital contributor to the 17 culture, economy, and life of the people of Washington. Yet federal 18 law prohibits some immigrants, who would otherwise be eligible for 19 medical coverage, from receiving the health benefits and timely 20 H-0968.1 HOUSE BILL 1612 State of Washington 66th Legislature 2019 Regular Session By Representatives Macri, Jinkins, Doglio, Riccelli, Cody, Peterson, Robinson, Dolan, Tharinger, Lekanoff, Senn, Slatter, Gregerson, Davis, Thai, Stonier, and Valdez p. 1 HB 1612 access to health care provided through federally funded coverage 1 programs. 2 (4) This lack of coverage negatively affects the reproductive 3 health, family planning, and reproductive autonomy of excluded 4 immigrants living in Washington state. 5 (5) Immigrants and other Washingtonians who are transgender and 6 gender nonconforming have important reproductive health care needs as 7 well. These needs go unmet when transgender and gender nonconforming 8 people are stigmatized when they seek care, or are denied critical 9 health services because of their gender. 10 (6) The literature review mandated by Substitute Senate Bill No. 11 6219 found that, "[a]ccording to 2015 U.S. Transgender Survey data, 12 thirty-two percent of transgender respondents in Washington State 13 reported that in the previous year they did not see a doctor when 14 needed because they could not afford it." 15 (7) Existing state law should be enhanced to ensure greater 16 coverage of and timely access to reproductive health care for the 17 benefit of all Washingtonians, regardless of immigration status, or 18 gender identity or expression. 19 (8) Because stigma is also a key barrier to access to 20 reproductive health care, all Washingtonians, regardless of gender 21 identity or immigration status, should be free from discrimination in 22 the provision of health care services, health care plan coverage, and 23 in access to publicly funded health coverage. 24 (9) All people should have access to additional services to 25 improve their reproductive health, without barriers such as cost 26 sharing. 27 NEW SECTION. Sec. 2. A new section is added to chapter 74.09 28 RCW to read as follows: 29 (1) By January 1, 2020, the authority shall administer a program 30 for individuals over nineteen years of age who would be eligible for 31 the Washington state family planning waiver program, currently known 32 as the take charge program, if not for 8 U.S.C. Sec. 1611 or 1612. 33 (2) The program shall provide services identical to those 34 services covered by the Washington state family planning waiver 35 program as of August 2018. 36 (3) The authority shall establish a comprehensive community 37 education and outreach campaign, working with stakeholder and 38 community organizations, to provide culturally and linguistically 39 p. 2 HB 1612 accessible information to facilitate participation in the program 1 including, but not limited to, enrollment procedures, program 2 services, and benefit utilization. 3 NEW SECTION. Sec. 3. A new section is added to chapter 74.09 4 RCW to read as follows: 5 (1) In administering reproductive health care services through 6 programs under this chapter, the authority and any managed care plans 7 and providers delivering or administering services purchased or 8 contracted for by the authority, must provide medically necessary 9 covered reproductive health care services to any covered person, 10 regardless of the covered person's gender identity or expression. 11 (2) The authority and any managed care plans delivering or 12 administering services purchased or contracted for by the authority, 13 may not issue automatic initial denials of coverage for reproductive 14 health care services that are ordinarily or exclusively available to 15 individuals of one gender, based on the fact that the individual's 16 gender assigned at birth, gender identity, or gender otherwise 17 recorded in one or more government-issued documents, is different 18 from the one to which such health services are ordinarily or 19 exclusively available. 20 (3) Denials as described in subsection (2) of this section are 21 prohibited discrimination under chapter 49.60 RCW. 22 (4) The definitions in this subsection apply throughout this 23 section unless the context clearly requires otherwise. 24 (a) "Body parts" includes, but is not limited to: Genitals, 25 gonads, the uterus, ovaries, fallopian tubes, breasts, and the 26 endocrine system. 27 (b) "Gender expression" means a person's gender-related 28 appearance and behavior, whether or not stereotypically associated 29 with the person's assigned gender at birth. 30 (c) "Gender identity" means a person's internal sense of the 31 person's own gender, regardless of the gender the person was assigned 32 at birth. 33 (d) "Reproductive health care services" means any medical 34 treatment, including pharmaceutical care, of reproductive processes, 35 functions, systems, and body parts involved in reproduction, in all 36 stages of life. 37 (5) This section must not be construed to authorize 38 discrimination on the basis of a covered person's gender identity or 39 p. 3 HB 1612 expression in the administration of any other medical assistance 1 programs administered by the authority. 2 Sec. 4. RCW 48.43.072 and 2018 c 119 s 2 are each amended to 3 read as follows: 4 (1) A health plan or student health plan, including student 5 health plans deemed by the insurance commissioner to have a short- 6 term limited purpose or duration or to be guaranteed renewable while 7 the covered person is enrolled as a regular full-time undergraduate 8 or graduate student at an accredited higher education institution, 9 issued or renewed on or after January 1, ((2019)) 2021, shall provide 10 coverage for: 11 (a)(i) All contraceptive drugs, devices, and other products, 12 approved by the federal food and drug administration, including 13 over-the-counter contraceptive drugs, devices, and products, approved 14 by the federal food and drug administration, regardless of whether 15 they are to be used by the covered person or the partner of the 16 covered person, and regardless of whether they are to be used for 17 contraception or exclusively for the prevention of sexually 18 transmitted infections; 19 (((b))) (ii) Voluntary sterilization procedures; 20 (((c))) (iii) The consultations, examinations, procedures, and 21 medical services that are necessary to prescribe, dispense, insert, 22 deliver, distribute, administer, or remove the drugs, devices, and 23 other products or services in (a) ((and (b))) (i) and (ii) of this 24 subsection. 25 (b) Pre-exposure prophylaxis and post-exposure prophylaxis. 26 (c) The following preventive services: 27 (i) Screening and counseling for physical, mental, sexual, and 28 reproductive health care needs following a sexual assault; 29 (ii) Breast cancer chemoprevention counseling for women who are 30 at increased risk for breast cancer, and risk-reducing medications 31 where medically appropriate; 32 (iii) Well-person preventive visits; 33 (iv) Annual screening and counseling for human papillomavirus for 34 those under thirty years of age, and screening and counseling every 35 five years for those between thirty and sixty-five years of age; 36 (v) Screening and counseling for anemia; and 37 (vi) Screening for: 38 (A) Urinary tract infection; and 39 p. 4 HB 1612 (B) Urinary incontinence. 1 (d) The following treatment services: 2 (i) Treatment for physical, mental, sexual, and reproductive 3 health care needs following a sexual assault; 4 (ii) Treatment for anemia; and 5 (iii) Treatment for: 6 (A) Urinary tract infection; and 7 (B) Urinary incontinence. 8 (e) Other reproductive health-related over-the-counter drugs and 9 products approved by the federal food and drug administration 10 including, but not limited to, prenatal vitamins for pregnant persons 11 and breast pumps for covered persons expecting the birth or adoption 12 of a child. 13 (2) The coverage required by subsection (1) of this section: 14 (a) May not require copayments, deductibles, or other forms of 15 cost sharing, with the exception of pre-exposure prophylaxis, the 16 treatment services required by subsection (1)(d) of this section, and 17 the drugs and products in subsection (1)(e) of this section, which 18 may be subject to cost sharing, unless the health plan is offered as 19 a qualifying health plan for a health savings account. For such a 20 qualifying health plan, the carrier must establish the plan's cost 21 sharing for the coverage required by subsection (1) of this section 22 at the minimum level necessary to preserve the enrollee's ability to 23 claim tax exempt contributions and withdrawals from ((his or her)) 24 the enrollee's health savings account under internal revenue service 25 laws and regulations; and 26 (b) May not require a prescription to trigger coverage of 27 over-the-counter contraceptive drugs, devices, and products, approved 28 by the federal food and drug administration. 29 (3) A health carrier may not deny the coverage required in 30 subsection (1) of this section because an enrollee changed ((his or 31 her)) the enrollee's contraceptive method within a twelve-month 32 period. 33 (4) Except as otherwise authorized under this section, a health 34 benefit plan may not impose any restrictions or delays on the 35 coverage required under this section, such as medical management 36 techniques that limit enrollee choice in accessing the full range of 37 contraceptive drugs, devices, or other products, approved by the 38 federal food and drug administration. 39 p. 5 HB 1612 (5) Benefits provided under this section must be extended to all 1 enrollees, enrolled spouses, and enrolled dependents. 2 (6) This section may not be construed to allow for denial of care 3 on the basis of race, color, national origin, sex, sexual 4 orientation, gender expression or identity, marital status, age, 5 citizenship, immigration status, or disability. 6 (7) A health plan or student health plan, including student 7 health plans deemed by the insurance commissioner to have a short- 8 term limited purpose or duration or to be guaranteed renewable while 9 the covered person is enrolled as a regular full-time undergraduate 10 or graduate student at an accredited higher education institution, 11 issued or renewed on or after January 1, 2021, may not issue 12 automatic initial denials of coverage for reproductive health care 13 services that are ordinarily or exclusively available to individuals 14 of one gender, based on the fact that the individual's gender 15 assigned at birth, gender identity, or gender otherwise recorded in 16 one or more government-issued documents, is different from the one to 17 which such health services are ordinarily or exclusively available. 18 (8) The definitions in this subsection apply throughout this 19 section unless the context clearly requires otherwise. 20 (a) "Body parts" includes, but is not limited to: Genitals, 21 gonads, the uterus, ovaries, fallopian tubes, breasts, and the 22 endocrine system. 23 (b) "Gender expression" means a person's gender-related 24 appearance and behavior, whether or not stereotypically associated 25 with the person's assigned gender at birth. 26 (c) "Gender identity" means a person's internal sense of the 27 person's own gender, regardless of the gender the person was assigned 28 at birth. 29 (d) "Reproductive health care services" means any medical 30 treatment, including pharmaceutical care, of reproductive processes, 31 functions, systems, and body parts involved in reproduction, in all 32 stages of life. 33 (e) "Well-person preventive visits" means the preventive annual 34 visits recommended by the federal health resources and services 35 administration women's preventive services guidelines, with the 36 understanding that those visits must be covered regardless of gender 37 identity or expression or perceived gender identity or expression. 38 (9) This section must not be construed to authorize 39 discrimination on the basis of gender identity or expression, or 40 p. 6 HB 1612 perceived gender identity or expression, in the provision of 1 nonreproductive health care services. 2 (10) The commissioner, under RCW 48.30.300, and the human rights 3 commission, under chapter 49.60 RCW shall share enforcement authority 4 over complaints of discrimination under this section as set forth in 5 RCW 49.60.178. 6 (11) The commissioner may adopt rules to implement this section. 7 NEW SECTION. Sec. 5. This act may be known and cited as the 8 reproductive health care access for all act. 9 NEW SECTION. Sec. 6. (1) Sections 2 and 3 of this act take 10 effect January 1, 2020. 11 (2) Section 4 of this act takes effect January 1, 2021. 12 --- END --- p. 7 HB 1612