The bill adds a new section to chapter 48.43 RCW and amends and reenacts RCW 41.05.017 to change health insurance coverage rules. For health plans issued or renewed on or after January 1, 2026, coverage for labor and delivery services may not be subject to the enrollee’s deductible. Any cost sharing an enrollee does pay for those services must be applied toward the enrollee’s deductible. For plans that cover labor and delivery and qualify as HSA‑eligible high‑deductible health plans, the health carrier must set the plan’s deductible for those services at the minimum level necessary to preserve the enrollee’s ability to make tax‑exempt HSA contributions under applicable Internal Revenue Service laws and regulations. Legally, the measure creates a new statutory provision and modifies existing law by reenacting and amending RCW 41.05.017 to make plans under that chapter explicitly subject to a list of specified RCW sections and to the new section. It also authorizes the Office of the Insurance Commissioner to adopt rules necessary to implement the act. Affected parties identified include health carriers, enrollees, plans governed by chapter 41.05 RCW, and HSA‑eligible qualifying health plans and holders. The extracted text does not provide statutory definitions for key terms (for example, “labor and delivery services,” “health plan,” “enrollee,” or “qualifying health plan for a health savings account”), does not show the full interaction with other provisions of chapter 48.43 or the listed RCWs, and does not specify how to determine the “minimum level necessary” for HSA tax treatment beyond reference to IRS laws and regulations. The extracted facts do not describe any changes to penalties.

Starting January 1, 2026, most people with Washington health plans can expect that charges for childbirth care will not be held back behind their plan deductible, so they will likely pay less out of pocket at the time of labor and delivery; insurers and employers that offer plans will likely see those claim costs sooner and may respond by changing premiums, plan designs, or employer contributions. Plans that must remain HSA‑eligible are an exception: carriers will limit any deductible for those services to the smallest amount needed to preserve HSA tax rules, which means HSA holders may still face a small deductible but not more than IRS rules allow; any copays or other cost sharing an enrollee does pay for childbirth must be credited toward their overall deductible so people do not lose credit for amounts they already paid. Who is most affected: people who are pregnant or expecting to give birth, health insurers and employers who fund or provide coverage, and holders of HSA‑compatible plans; insurers will bear earlier claims exposure and may pass costs to premiums or other benefits, while enrollees will usually face lower immediate out‑of‑pocket costs for delivery. Key implementation details are unclear from the provided text—important terms like exactly what counts as "labor and delivery services" and how to determine the IRS‑based minimum deductible for HSA plans are not defined here, and the insurance commissioner must still issue rules to clarify those points.