This bill adds a new section to chapter 41.05 RCW that prohibits a health carrier acting as a third-party administrator (TPA) for a self-funded plan offered to employees or school employees under that chapter from requiring a hospital system owned or operated by the state of Washington to participate in any commercial health plan or product offered or administered by the health carrier as a condition for negotiating with or participating in the self-funded plan. The bill refers to the statutory definition of "health carrier" in RCW 48.43.005. Legally, the bill creates a new statutory prohibition on a contracting practice by TPAs; it is a procedural/contracting restriction rather than the creation of a new crime or a specified penalty. Affected parties named in the text include health carriers acting as TPAs, self-funded plans under chapter 41.05, state-owned or -operated hospital systems, and the covered employees and school employees. The bill was first read on 01/31/25, is identified as House Bill 1766 (H-0998.1), 69th Legislature, 2025 Regular Session, and was referred to the Committee on Health Care & Wellness. The text provided does not include an effective date, enforcement mechanisms, penalties for violations, or whether the rule applies retroactively or to existing contracts. The terms "third-party administrator," "self-funded plan," and "hospital system owned or operated by the state of Washington" are used but not defined in the excerpt (the bill references the definition of "health carrier" to RCW 48.43.005); if other relevant sections of chapter 41.05 RCW or additional implementing provisions exist, they are not included here.

If enacted, the bill would stop health insurers who serve as third-party administrators for state employee and school employee self-funded plans from forcing state-owned hospital systems to join the insurer’s commercial plans as a condition of negotiating or participating in those self-funded plans. That will take away a common bargaining chip insurers use, giving state-owned hospital systems more ability to agree to participate on their own terms and likely changing how insurers negotiate access to those hospitals. The groups most affected are health carriers acting as TPAs, state-owned hospital systems, and the self-funded plans that cover state and school employees. Carriers may face more complex negotiations and lose leverage that could otherwise influence contract terms or network design, which could change their costs or the way they price or offer products; state hospital systems gain more control over whether and how they participate, which could affect their revenue mix. The bill text does not include an effective date, enforcement details, or instructions about existing contracts, so how quickly and to what extent these changes happen is unclear.