This bill creates a new state law section requiring the Washington State Health Care Authority (HCA) to develop and submit a state plan amendment to the federal Centers for Medicare and Medicaid Services (CMS) by July 1, 2027. The proposed amendment would seek to allow individuals with countable income equal to or below 300 percent of the federal poverty level, adjusted for family size and determined annually by the U.S. Department of Health and Human Services, to be eligible for enrollment in the medical assistance program under chapter 74.09 RCW. Legally, the change is a procedural requirement directed at HCA to pursue a federal plan amendment intended to expand eligibility; it creates a new statutory duty for the agency rather than directly amending federal law or automatically changing eligibility. The provision names the affected agencies (HCA, CMS, and HHS) and the target population, and it is presented as a new section of state law. The text supplied does not define how “countable income” is to be calculated, does not explain what will occur after the amendment is submitted or if federal approval is obtained, and does not include implementation details, funding, exclusions, or other administrative procedures. It is also not clear from these facts whether additional related provisions appear elsewhere in the bill.

If the federal government approves the amendment the Health Care Authority is required to submit by July 1, 2027, people with incomes up to 300 percent of the federal poverty level (adjusted for family size each year) could become eligible for Washington’s medical assistance program, which would likely increase the number of people enrolled and raise program spending and demand for services. The practical effect is a potential expansion of coverage and access for that income group, but only if CMS approves the state plan amendment. The Health Care Authority will take on the work and short-term costs of developing and submitting the amendment, and the federal Centers for Medicare and Medicaid Services will need to review it; individuals at or below the 300 percent threshold are the main beneficiaries if approved. Key details are missing from the text provided—most importantly how “countable income” is calculated, whether the state will provide funding to cover higher enrollment, and what happens if the amendment is not approved—so the timing, budget impacts, and final scope of any expansion remain uncertain.