This bill adds a new section to chapter 43.70 RCW authorizing the Department of Health (DOH) to issue immunization recommendations and related guidance, directing the department to consider ACIP and other experts and to base decisions on reasonable scientific evidence and judgment. DOH recommendations and guidance must be posted on the department’s website and are not subject to rule-making under chapter 34.05 RCW. The bill amends RCW 48.43.047 to require nongrandfathered health plans issued on or after April 1, 2026, to cover specified preventive services: U.S. Preventive Services Task Force A and B services in effect June 30, 2025, HRSA comprehensive guidelines for infants/children/adolescents and for women in effect June 30, 2025, and immunizations recommended by DOH under the new section. Coverage must follow federal rules and DOH guidance in effect June 30, 2025, become effective for plan years beginning one year after a recommendation or guideline is issued, generally prohibit cost-sharing for in-network preventive services (and for out-of-network providers when no in-network provider exists), allow minimal cost-sharing only to preserve HSA tax benefits, permit reasonable medical management where recommendations are silent, and authorize the insurance commissioner to adopt implementing rules that are at least as favorable to enrollees and developed in consultation with DOH and the Health Care Authority. The bill also amends RCW 70.290.010 and RCW 70.290.040 to update definitions and procedures related to the Washington vaccine association and the universal vaccine purchase account. It defines terms including covered lives, state supplied vaccine, health carrier, and third-party administrator; limits covered lives to persons under age 19 except those whose vaccines are federally funded or covered by specified state programs; defines vaccine as an immunization recommended by DOH under the new section for persons under 19 and FDA approved. It requires the secretary to subtract costs for children in certain state-purchased programs lacking federal vaccine funding and report the final amount to the association; directs the association’s board to determine assessment methodology and collection timing, to assess licensed health carriers and third-party administrators for their share of nonfederal program costs (including administrative costs), and to develop an attribution mechanism with specified data elements and privacy protections. The board must factor attribution results annually beginning November 1, 2011; if assessments fall short, the association must remit the difference to the state and may assess members for shortfalls; prepayments and an initial deposit into the universal vaccine purchase account by April 30, 2010, are authorized. The act includes a severability clause and takes effect immediately. Certain details are incomplete or not provided in the extracted text: subsection (1) referenced in the assessment and calculation provisions is missing, the remainder of RCW 70.290.040 ends mid-sentence so prioritization details are unclear, formal definitions or identifications of the “secretary” and the “association” are not fully shown in the second chunk, and the DOH website posting requirements and any additional provisions appearing elsewhere in the bill are not available in these extracts.

If enacted, the bill would make insurers cover a wider set of recommended preventive services and any immunizations the state Department of Health recommends, generally without copays when an in-network provider is used (and without cost-sharing even if only an out-of-network provider is available). That will likely increase health carriers’ short-term medical costs and change plan administration because nongrandfathered plans issued on or after April 1, 2026 must follow preventive care guidance effective June 30, 2025 and implement DOH immunization recommendations a year after they are issued; HSA-eligible plans can still apply minimal cost-sharing where needed to protect tax status. The Department of Health gains clear authority to issue vaccine recommendations outside the formal rule-making process, which may speed when new immunizations become covered. The state also shifts the financial and administrative burden for vaccinating children onto the Washington vaccine association, its member health carriers, third-party administrators, and public payers: carriers and TPAs will be assessed for the nonfederal vaccine program cost (as estimated by the DOH secretary) and must remit payments, with state and local governments and school districts also responsible for their shares. The association’s board will set assessment methods intended to reflect actual vaccine usage and must build an attribution system that records date of service, patient name, vaccine given, and health plan eligibility (data kept under privacy laws), and annual assessments will be adjusted using those results; if assessments fall short the association must cover the gap or bill members. Key implementation details—exact formulas, some prioritization language, and how historic dates in the text apply—are incomplete in the provided excerpts, so the precise cost impact and timing for assessments and purchases remain uncertain.