Text of WA SB 5602 (2019)

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 S-0916.1 SENATE BILL 5602 State of Washington 66th Legislature 2019 Regular Session By Senators Randall, Wilson, C., Nguyen, Das, Saldaña, Cleveland, Takko, Kuderer, Hasegawa, Rolfes, Van De Wege, Keiser, Hunt, Wellman, Billig, Dhingra, Conway, Pedersen, Frockt, Salomon, Palumbo, Darneille, McCoy, Liias, Mullet, and Carlyle p. 1 SB 5602 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 SB 5602 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 SB 5602 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 SB 5602 (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 SB 5602 (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 SB 5602 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 SB 5602

CERTIFICATION OF ENROLLMENT SECOND SUBSTITUTE SENATE BILL 5602 Chapter 399, Laws of 2019 66th Legislature 2019 Regular Session REPRODUCTIVE HEALTH CARE BARRIERS EFFECTIVE DATE: July 28, 2019—Except for section 2, which becomes effective January 1, 2020; section 3, which becomes effective January 1, 2021; and section 5, which becomes effective May 13, 2019. Passed by the Senate April 26, 2019 Yeas 29 Nays 20 CYRUS HABIB President of the Senate Passed by the House April 25, 2019 Yeas 58 Nays 40 FRANK CHOPP Speaker of the House of Representatives CERTIFICATE I, Brad Hendrickson, Secretary of the Senate of the State of Washington, do hereby certify that the attached is SECOND SUBSTITUTE SENATE BILL 5602 as passed by the Senate and the House of Representatives on the dates hereon set forth. BRAD HENDRICKSON Secretary Approved May 13, 2019 4:50 PM FILED May 16, 2019 JAY INSLEE Governor of the State of Washington Secretary of State State of Washington AN ACT Relating to eliminating barriers to reproductive health 1 care for all; amending RCW 48.43.072; adding a new section to chapter 2 74.09 RCW; adding a new section to chapter 70.41 RCW; adding a new 3 section to chapter 48.43 RCW; adding a new section to chapter 70.250 4 RCW; creating new sections; providing effective dates; and declaring 5 an emergency. 6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: 7 NEW SECTION. Sec. 1. The legislature finds and declares: 8 (1) It is the public policy of this state to provide the maximum 9 access to reproductive health care and reproductive health care 10 coverage for all people in Washington state. 11 (2) In 2018, the legislature passed Substitute Senate Bill No. 12 6219. Along with reproductive health care coverage requirements, the 13 bill mandated a literature review of barriers to reproductive health 14 care. As documented by the report submitted to the legislature on 15 January 1, 2019, young people, immigrants, people living in rural 16 communities, transgender and gender nonconforming people, and people 17 of color still face significant barriers to getting the reproductive 18 health care they need. 19 (3) Washingtonians who are transgender and gender nonconforming 20 have important reproductive health care needs as well. These needs go 21 SECOND SUBSTITUTE SENATE BILL 5602 AS AMENDED BY THE HOUSE Passed Legislature - 2019 Regular Session State of Washington 66th Legislature 2019 Regular Session By Senate Ways & Means (originally sponsored by Senators Randall, Wilson, C., Nguyen, Das, Saldaña, Cleveland, Takko, Kuderer, Hasegawa, Rolfes, Van De Wege, Keiser, Hunt, Wellman, Billig, Dhingra, Conway, Pedersen, Frockt, Salomon, Palumbo, Darneille, McCoy, Liias, Mullet, and Carlyle) READ FIRST TIME 03/01/19. p. 1 2SSB 5602.SL unmet when, in the process of seeking care, transgender and gender 1 nonconforming people are stigmatized or are denied critical health 2 services because of their gender identity or expression. 3 (4) The literature review mandated by Substitute Senate Bill No. 4 6219 found that, "[a]ccording to 2015 U.S. Transgender Survey data, 5 thirty-two percent of transgender respondents in Washington State 6 reported that in the previous year they did not see a doctor when 7 needed because they could not afford it." 8 (5) Existing state law should be enhanced to ensure greater 9 coverage of and timely access to reproductive health care for the 10 benefit of all Washingtonians, regardless of gender identity or 11 expression. 12 (6) Because stigma is also a key barrier to access to 13 reproductive health care, all Washingtonians, regardless of gender 14 identity, should be free from discrimination in the provision of 15 health care services, health care plan coverage, and in access to 16 publicly funded health coverage. 17 (7) All people should have access to robust reproductive health 18 services to maintain and improve their reproductive health. 19 NEW SECTION. Sec. 2. A new section is added to chapter 74.09 20 RCW to read as follows: 21 (1) In the provision of reproductive health care services through 22 programs under this chapter, the authority, managed care plans, and 23 providers that administer or deliver such services may not 24 discriminate in the delivery of a service provided through a program 25 of the authority based on the covered person's gender identity or 26 expression. 27 (2) The authority and any managed care plans delivering or 28 administering services purchased or contracted for by the authority, 29 may not issue automatic initial denials of coverage for reproductive 30 health care services that are ordinarily or exclusively available to 31 individuals of one gender, based on the fact that the individual's 32 gender assigned at birth, gender identity, or gender otherwise 33 recorded in one or more government-issued documents, is different 34 from the one to which such health services are ordinarily or 35 exclusively available. 36 (3) Denials as described in subsection (2) of this section are 37 prohibited discrimination under chapter 49.60 RCW. 38 p. 2 2SSB 5602.SL (4) The definitions in this subsection apply throughout this 1 section unless the context clearly requires otherwise. 2 (a) "Gender expression" means a person's gender-related 3 appearance and behavior, whether or not stereotypically associated 4 with the person's gender assigned at birth. 5 (b) "Gender identity" means a person's internal sense of the 6 person's own gender, regardless of the person's gender assigned at 7 birth. 8 (c) "Reproductive health care services" means any medical 9 services or treatments, including pharmaceutical and preventive care 10 service or treatments, directly involved in the reproductive system 11 and its processes, functions, and organs involved in reproduction, in 12 all stages of life. Reproductive health care services does not 13 include infertility treatment. 14 (d) "Reproductive system" includes, but is not limited to: 15 Genitals, gonads, the uterus, ovaries, fallopian tubes, and breasts. 16 (5) This section must not be construed to authorize 17 discrimination on the basis of a covered person's gender identity or 18 expression in the administration of any other medical assistance 19 programs administered by the authority. 20 Sec. 3. RCW 48.43.072 and 2018 c 119 s 2 are each amended to 21 read as follows: 22 (1) A health plan ((issued or renewed on or after January 1, 23 2019,)) or student health plan, including student health plans deemed 24 by the insurance commissioner to have a short-term limited purpose or 25 duration or to be guaranteed renewable while the covered person is 26 enrolled as a regular full-time undergraduate or graduate student at 27 an accredited higher education institution, shall provide coverage 28 for: 29 (a) All contraceptive drugs, devices, and other products, 30 approved by the federal food and drug administration, including 31 over-the-counter contraceptive drugs, devices, and products, approved 32 by the federal food and drug administration. This includes condoms, 33 regardless of the gender or sexual orientation of the covered person, 34 and regardless of whether they are to be used for contraception or 35 exclusively for the prevention of sexually transmitted infections; 36 (b) Voluntary sterilization procedures; 37 (c) The consultations, examinations, procedures, and medical 38 services that are necessary to prescribe, dispense, insert, deliver, 39 p. 3 2SSB 5602.SL distribute, administer, or remove the drugs, devices, and other 1 products or services in (a) and (b) of this subsection((.)); 2 (d) The following preventive services: 3 (i) Screening for physical, mental, sexual, and reproductive 4 health care needs that arise from a sexual assault; and 5 (ii) Well-person preventive visits; 6 (e) Medically necessary services and prescription medications for 7 the treatment of physical, mental, sexual, and reproductive health 8 care needs that arise from a sexual assault; and 9 (f) The following reproductive health-related over-the-counter 10 drugs and products approved by the federal food and drug 11 administration: Prenatal vitamins for pregnant persons; and breast 12 pumps for covered persons expecting the birth or adoption 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((,)): 16 (i) Except for: 17 (A) The medically necessary services and prescription medications 18 required by subsection (1)(e) of this section; and 19 (B) The drugs and products in subsection (1)(f) of this section; 20 or 21 (ii) Unless the health plan is offered as a qualifying health 22 plan for a health savings account. For such a qualifying health plan, 23 the carrier must establish the plan's cost sharing for the coverage 24 required by subsection (1) of this section at the minimum level 25 necessary to preserve the enrollee's ability to claim tax exempt 26 contributions and withdrawals from ((his or her)) the enrollee's 27 health savings account under internal revenue service laws and 28 regulations; and 29 (b) May not require a prescription to trigger coverage of 30 over-the-counter contraceptive drugs, devices, and products, approved 31 by the federal food and drug administration, except those 32 reproductive health related drugs and products as set forth in 33 subsection (1)(f) of this section. 34 (3) A health carrier may not deny the coverage required in 35 subsection (1) of this section because an enrollee changed ((his or 36 her)) the enrollee's contraceptive method within a twelve-month 37 period. 38 (4) Except as otherwise authorized under this section, a health 39 benefit plan may not impose any restrictions or delays on the 40 p. 4 2SSB 5602.SL coverage required under this section, such as medical management 1 techniques that limit enrollee choice in accessing the full range of 2 contraceptive drugs, devices, or other products, approved by the 3 federal food and drug administration. 4 (5) Benefits provided under this section must be extended to all 5 enrollees, enrolled spouses, and enrolled dependents. 6 (6) This section may not be construed to allow for denial of care 7 on the basis of race, color, national origin, sex, sexual 8 orientation, gender expression or identity, marital status, age, 9 citizenship, immigration status, or disability. 10 (7) A health plan or student health plan, including student 11 health plans deemed by the insurance commissioner to have a short- 12 term limited purpose or duration or to be guaranteed renewable while 13 the covered person is enrolled as a regular full-time undergraduate 14 or graduate student at an accredited higher education institution, 15 issued or renewed on or after January 1, 2021, may not issue 16 automatic initial denials of coverage for reproductive health care 17 services that are ordinarily or exclusively available to individuals 18 of one gender, based on the fact that the individual's gender 19 assigned at birth, gender identity, or gender otherwise recorded in 20 one or more government-issued documents, is different from the one to 21 which such health services are ordinarily or exclusively available. 22 (8) The definitions in this subsection apply throughout this 23 section unless the context clearly requires otherwise. 24 (a) "Gender expression" means a person's gender-related 25 appearance and behavior, whether or not stereotypically associated 26 with the person's gender assigned at birth. 27 (b) "Gender identity" means a person's internal sense of the 28 person's own gender, regardless of the person's gender assigned at 29 birth. 30 (c) "Reproductive health care services" means any medical 31 services or treatments, including pharmaceutical and preventive care 32 service or treatments, directly involved in the reproductive system 33 and its processes, functions, and organs involved in reproduction, in 34 all stages of life. Reproductive health care services does not 35 include infertility treatment. 36 (d) "Reproductive system" includes, but is not limited to: 37 Genitals, gonads, the uterus, ovaries, fallopian tubes, and breasts. 38 (e) "Well-person preventive visits" means the preventive annual 39 visits recommended by the federal health resources and services 40 p. 5 2SSB 5602.SL administration women's preventive services guidelines, with the 1 understanding that those visits must be covered for women, and when 2 medically appropriate, for transgender, nonbinary, and intersex 3 individuals. 4 (9) This section may not be construed to authorize discrimination 5 on the basis of gender identity or expression, or perceived gender 6 identity or expression, in the provision of nonreproductive health 7 care services. 8 (10) The commissioner, under RCW 48.30.300, and the human rights 9 commission, under chapter 49.60 RCW shall share enforcement authority 10 over complaints of discrimination under this section as set forth in 11 RCW 49.60.178. 12 (11) The commissioner may adopt rules to implement this section. 13 NEW SECTION. Sec. 4. A new section is added to chapter 70.41 14 RCW to read as follows: 15 (1) By September 1, 2019, every hospital must submit to the 16 department its policies related to access to care regarding: 17 (a) Admission; 18 (b) Nondiscrimination; and 19 (c) Reproductive health care. 20 (2) The department shall post a copy of the policies received 21 under subsection (1) of this section on its web site. 22 (3) If a hospital makes changes to any of the policies listed 23 under subsection (1) of this section, it must submit a copy of the 24 changed policy to the department within thirty days after the 25 hospital approves the changes. 26 (4) A hospital must post a copy of the policies provided to the 27 department under subsection (1) of this section and the form required 28 under subsection (5) of this section to the hospital's own web site 29 in a location where the policies are readily accessible to the public 30 without a required login or other restriction. 31 (5) By September 1, 2019, the department shall, in consultation 32 with stakeholders including a hospital association and patient 33 advocacy groups, develop a simple and clear form to be submitted by 34 hospitals along with the policies required in subsection (1) of this 35 section. The form must provide the public with specific information 36 about which reproductive health care services are and are not 37 generally available at each hospital. The form must include contact 38 p. 6 2SSB 5602.SL information for the hospital in case patients have specific questions 1 about services available at the hospital. 2 NEW SECTION. Sec. 5. A new section is added to chapter 48.43 3 RCW to read as follows: 4 (1) The legislature intends to codify the state's current 5 practice of requiring health carriers to bill enrollees with a single 6 invoice and to segregate into a separate account the premium 7 attributable to abortion services for which federal funding is 8 prohibited. Washington has achieved full compliance with section 1303 9 of the federal patient protection and affordable care act by 10 requiring health carriers to submit a single invoice to enrollees and 11 to segregate into a separate account the premium amounts attributable 12 to coverage of abortion services for which federal funding is 13 prohibited. Further, section 1303 states that the act does not 14 preempt or otherwise have any effect on state laws regarding the 15 prohibition of, or requirement of, coverage, funding, or procedural 16 requirements on abortions. 17 (2) In accordance with RCW 48.43.073 related to requirements for 18 coverage and funding of abortion services, an issuer offering a 19 qualified health plan must: 20 (a) Bill enrollees and collect payment through a single invoice 21 that includes all benefits and services covered by the qualified 22 health plan; and 23 (b) Include in the segregation plan required under applicable 24 federal and state law a certification that the issuer's billing and 25 payment processes meet the requirements of this section. 26 NEW SECTION. Sec. 6. A new section is added to chapter 70.250 27 RCW to read as follows: 28 (1) No later than January 1, 2020, the collaborative shall begin 29 a review to identify, define, and endorse guidelines for the 30 provision of high quality sexual and reproductive health services in 31 clinical settings throughout Washington. This shall include the 32 development of specific clinical recommendations to improve sexual 33 and reproductive health care for: 34 (a) People of color; 35 (b) Immigrants and refugees; 36 (c) Victims and survivors of violence; and 37 (d) People with disabilities. 38 p. 7 2SSB 5602.SL (2) The collaborative shall conduct its review consistent with 1 the activities, processes, and reporting standards specified in RCW 2 70.250.050. In conducting its review, the collaborative shall apply a 3 whole-person framework to develop evidence-based, culturally 4 sensitive recommendations to improve standards of care and health 5 equity. 6 (3) By December 15, 2020, the collaborative, through the 7 authority, shall provide a status report to the committees of the 8 legislature with jurisdiction over matters related to health care and 9 to the governor. 10 NEW SECTION. Sec. 7. The department of health shall develop 11 recommendations for increasing awareness about financial support that 12 is available for preexposure and postexposure prophylaxis. The 13 department of health shall consult with the state board of health, 14 the health care authority, and the health benefit exchange in 15 developing its recommendation related to outreach and education to 16 affected populations. By December 1, 2019, the department of health 17 shall provide its recommendations to the appropriate committees of 18 the legislature. 19 NEW SECTION. Sec. 8. This act may be known and cited as the 20 reproductive health care access for all act. 21 NEW SECTION. Sec. 9. (1) Section 2 of this act takes effect 22 January 1, 2020. 23 (2) Section 3 of this act takes effect January 1, 2021. 24 NEW SECTION. Sec. 10. Section 5 of this act is necessary for 25 the immediate preservation of the public peace, health, or safety, or 26 support of the state government and its existing public institutions, 27 and takes effect immediately. 28 Passed by the Senate April 26, 2019. Passed by the House April 25, 2019. Approved by the Governor May 13, 2019. Filed in Office of Secretary of State May 16, 2019. --- END --- p. 8 2SSB 5602.SL