This bill creates a new law by adding sections to chapter 41.05 RCW to establish the Washington health care board and to direct that board to design and implement the Washington health plan, a statewide program intended to provide all medically necessary health care services to all state residents. Implementation of the plan is explicitly conditioned on the state obtaining an unspecified federal waiver for a state-based universal health care plan, receiving federal funding to support implementation, and the legislature enacting any necessary implementing legislation. The act’s effective date is contingent on federal law authorizing a state to obtain the required waiver and federal funding. The board is a new 19-member, governor-appointed body representing specified stakeholder categories (including employers, practicing health care providers across multiple professions, health-related agencies, facility directors, financing and drug purchasing experts, a tribal representative, and organized labor). Members serve four-year terms and must select a chair from among themselves. Assigned duties include designing the plan, conducting or contracting actuarial and economic analyses, hiring staff, setting an implementation timeline, submitting required federal waivers and funding requests, making legislative recommendations (either after waiver approval or earlier if federal law or regulation requires), administering the plan once implemented, and consulting or coordinating with the universal health care commission. The text also states that “the authority may adopt any rules necessary to implement this section,” and requires the health care authority to provide written notice of the act’s effective date to specified legislative and administrative recipients. This is primarily a structural and procedural change establishing a new board and program; it does not create a crime or change penalties. Important details are missing or unclear in the provided text, including which specific “authority” may adopt rules, the detailed appointment process or qualifications, meeting/quorum or conflict-of-interest rules, which specific federal waiver or statute is required, funding mechanisms, timelines, and detailed plan content.

If enacted, the bill creates a new 19-member Washington health care board appointed by the governor to design and, if federal approval and funding are secured and the legislature passes any needed implementing laws, run a statewide Washington health plan that would cover all medically necessary health care for every state resident. Practically, this shifts the job of planning and standing up a universal coverage program to a single board that will hire staff, commission actuarial and economic analyses, set timelines, seek federal waivers and funding, make legislative recommendations, and coordinate with the existing universal health care commission. Most affected are state agencies, health care providers, employers, labor organizations, tribes, and the legislature. Board members and the represented stakeholder groups will take on new planning and administrative responsibilities; the Health Care Authority must send formal notice when the act’s effective date is triggered. Actual costs, timelines, and who pays depend on securing an unspecified federal waiver and federal funds and on any implementing legislation, so there is significant uncertainty about funding sources, detailed plan rules, appointment procedures, and the exact powers of the “authority” that may adopt rules.