This bill reenacts and amends RCW 43.71B.010 and adds a new section to chapter 43.71B RCW. It directs the Health Care Authority to apply to the Centers for Medicare and Medicaid Services for a Social Security Act section 1115(a) waiver no later than July 1, 2026 to obtain expenditure authority to cover traditional health care practices. If CMS approves the waiver, the authority must provide coverage, in accordance with CMS requirements, for traditional health care practices received through Indian Health Service facilities, facilities operated by tribes under the Indian Self-Determination and Education Assistance Act, or facilities operated by urban Indian organizations under Title V of the Indian Health Care Improvement Act, for Medicaid beneficiaries who are able to receive services delivered by or through those facilities. Legally, the bill is a procedural change that reenacts and amends existing statute, adds a new statutory section, and creates a conditional coverage requirement that depends on federal waiver approval. The bill also supplies and updates statutory definitions (for example, of traditional health care practices, community health aide, Indian health care provider, tribe, tribal organization, and urban Indian organization). It does not create a new crime or change penalties. The bill affects the Health Care Authority, CMS, the Indian Health Service, tribes and tribal organizations operating facilities under federal law, urban Indian organizations, and Medicaid beneficiaries receiving services at those facilities. The text references other RCW sections (43.71B.020, .030, .040) and several federal statutes. Important implementation details are not included here: the content of the advisory plan and the advisory council’s duties, functions of the reinvestment committee, the specific timeline or procedures for implementing coverage after CMS approval, and how eligibility or the phrase “able to receive services delivered by or through these facilities” will be determined.

If enacted, the state will require the Health Care Authority to seek federal permission by July 1, 2026 so Medicaid can pay for traditional Indigenous health practices delivered at Indian Health Service facilities, tribally run clinics, or urban Indian organizations. That would likely increase access to culturally based treatments for Medicaid enrollees who use those sites and create a new source of Medicaid payments for those tribal and urban Indian providers. The practical tradeoffs are that the Health Care Authority must incur the cost and work to apply for and then implement a CMS waiver and meet federal rules, while tribes, IHS facilities, and urban Indian organizations could gain Medicaid revenue but must comply with CMS coverage and billing requirements. The text references possible state savings and a reinvestment account, but key details about which specific practices will be covered, how eligibility will be determined, and the timing and mechanics of implementation are not provided.