This bill adds new statutory sections that require many Washington health plans to cover fertility-related services. For group health plans other than small group plans and for state employee health plans, the bill requires coverage of "standard fertility preservation services" for plans issued or renewed on or after January 1, 2026, and requires coverage of diagnosis and treatment for infertility for plans issued or renewed on or after January 1, 2027. The infertility coverage specified includes two completed oocyte retrievals with unlimited embryo transfers and the use of single embryo transfer when recommended and medically appropriate. The act is titled the "Washington state building families act." The bill also prohibits covered plans from imposing different exclusions, limits, or cost-sharing on fertility medications, infertility diagnosis and treatment, and standard fertility preservation services compared to non-infertility-related services, except as provided in the same statutory section. It requires benefits to be provided to enrollees, covered spouses, and covered nonspouse dependents to the same extent as other pregnancy-related benefits. The Health Care Authority is directed to provide coverage for standard fertility preservation services and Medicaid managed care organizations are subject to the same prohibitions on differential restrictions. The insurance commissioner is authorized to adopt rules to implement and enforce the new group insurance section. Several details are not present in the extracted text. The bill does not define "small group health plans" within these excerpts, the effective date for the Health Care Authority/Medicaid coverage requirement is not specified here, and the phrase "except as provided in this section" suggests possible exceptions that are not visible in these facts. The text provided also does not include enforcement mechanisms, penalties, funding sources, administrative procedures beyond insurance commissioner rulemaking, coverage rules for the individual market, or how differing professional guidelines would be resolved.

If enacted, large employer group health plans and the state employee health plan will have to expand benefits so more people and their covered family members can get fertility preservation and, by early 2027, standard infertility diagnosis and treatment that can include two egg retrievals and unlimited embryo transfers when medically appropriate. Medicaid’s governing authority is also required to cover fertility preservation services, and all covered plans must stop treating fertility medications or services differently from other prescription drugs or pregnancy-related benefits, so more enrollees will see those services covered with the same cost-sharing rules as other care. The immediate practical impacts fall on large-group insurers, the Health Care Authority and Medicaid managed care organizations, and the state as plan sponsor: they will likely face higher claims costs, need to change benefit designs and cost-sharing structures, and may need budget adjustments to pay for the added services. Small group and individual market plans are largely excluded, and important implementation details are missing from the provided text—most notably the definition of “small group,” the exact start date for Medicaid changes, any exceptions, and how the new requirements will be funded or enforced—so the scale and timing of fiscal impacts remain uncertain.