This bill adds a new section to chapter 48.43 RCW that prohibits cost-sharing in nongrandfathered health plans that provide maternity coverage for specified in-network prenatal and postnatal services and, beginning later, for prescription drugs used to treat pregnancy-related conditions. The prohibition on cost-sharing for listed prenatal and postnatal services applies to plans issued or renewed on or after January 1, 2026; the prohibition for prescription drugs begins for plans issued or renewed on or after January 1, 2027. Health plans offered as qualifying health savings account (HSA) plans must limit any required cost-sharing for these services to the minimum necessary to preserve the enrollee’s ability to make tax-exempt HSA contributions under applicable IRS rules. The office of the insurance commissioner is authorized to adopt rules to implement the new section. The bill defines the prenatal services period as beginning on the date of the carrier’s first claim showing a pregnancy-related or pregnancy complication diagnosis and continuing until delivery or pregnancy end, and it requires coverage without cost-sharing for all claims in that period that include such diagnosis codes. The postnatal services period is defined as 12 weeks following delivery for claims with pregnancy-related or complication-related diagnosis codes, and from 12 weeks up to one year after delivery for claims with a pregnancy complication diagnosis; those claims must be covered without cost-sharing. The text lists example services (for example, office visits, laboratory services, imaging, prenatal screening tests, prenatal vitamins, lactation specialists, cesarean follow-up care, counseling and therapy) but does not provide an exhaustive list. The act also reenacts and amends RCW 41.05.017 and lists applicability of a set of RCW sections to plans under chapter 41.05 RCW. Affected entities include nongrandfathered private health plans that provide maternity services, plans offered as HSA-qualifying plans, and health plans providing medical insurance under chapter 41.05 RCW; the office of the insurance commissioner has rulemaking authority to implement the provisions. Several details are not provided in the extracted text: the bill uses but does not define “nongrandfathered health plan,” it does not comprehensively list all covered services, it does not define what counts as a “qualifying health plan for a health savings account,” it does not show the precise changes made when reenacting and amending RCW 41.05.017, and it does not include penalties, enforcement mechanisms, or administrative procedures beyond granting rulemaking authority.

If enacted, people enrolled in nongrandfathered health plans that cover maternity care will generally no longer pay copays, deductibles, or other cost-sharing for a range of in‑network prenatal and early postnatal services beginning for plans issued or renewed on or after January 1, 2026, and for prescription drugs tied to pregnancy conditions beginning for plans issued or renewed on or after January 1, 2027. The no‑cost periods start with the first claim showing a pregnancy diagnosis and run through delivery for prenatal care, then 12 weeks after delivery for pregnancy‑related claims and up to one year for claims tied to pregnancy complications. The most affected parties are insurers and employers who offer nongrandfathered plans, including plans under chapter 41.05 RCW, because they will be required to absorb those out‑of‑pocket costs or adjust plan designs and funding to comply; health plans that qualify for health savings accounts must still preserve HSA tax rules by keeping cost sharing at the minimum allowed. The office of the insurance commissioner will write implementing rules, but important details are unclear here—such as how “nongrandfathered” is defined, the full list of covered services, how HSA‑qualified plan limits are applied, and what enforcement or penalties (if any) will be used—so insurers and employers will face some uncertainty while rules are developed.