This bill creates a new annual coverage assessment on health carriers subject to tax under RCW 48.14.020 or 48.14.0201 and deposits the revenue into a newly created "abortion savings account" in the state treasury. The first-year assessment is set at $0.82 per prior-calendar-year coverage month and subsequent years at $0.165 per prior-calendar-year coverage month. Health carriers must file an annual coverage month assessment statement with the insurance commissioner by March 1 each year; late payments incur tiered penalties (5% by month-end, 10% by 45 days, 20% by 60 days) plus interest beginning 61 days after due date at the maximum legal rate under RCW 19.52.020. The commissioner may collect by distraint or judicial action and may suspend a delinquent carrier’s certificate of authority or registration until amounts are paid; refunds of overpayments are available on written request within six years. The assessment must be borne by carriers and may not be passed through to enrollees except if the commissioner determines pass-through is necessary to avoid significant carrier insolvency risk or consumer harm; carriers must show compliance through the commissioner’s rate filing review and the commissioner may adopt implementing rules. The bill establishes an "abortion savings program" to provide grants to maintain access to direct patient abortion clinical care services for individuals in the state, directs the responsible department to provide operating grants to eligible organizations (as defined) subject to appropriations, and requires that at least 85 percent of funds appropriated for the program be awarded as grants. The department is prohibited, except as required for program operation, from releasing or collecting identifying information for staff of applicant or grantee organizations, individual practitioners or staff who provide direct patient abortion clinical care for grantees, and individuals who request or obtain support; such identifying information is declared exempt from public inspection and copying under chapter 42.56 RCW. Definitions in the act include "coverage month," "health carrier," "eligible organization," "identifying information," and "individuals without sufficient resources." Moneys in the abortion savings account may be spent only after appropriation and only for grants under the program. Separately, the bill reenacts and amends RCW 43.84.092 to establish or reaffirm a treasury income account to receive all earnings on investments of surplus treasury balances, requires monthly distribution of those earnings, directs the state treasurer to credit the general fund except that many specified accounts and funds receive a proportionate share based on average daily balances, and requires earnings from certain permanent funds be allocated to their beneficiary accounts. The Office of Financial Management is authorized to determine amounts due to or from the federal government under the federal Cash Management Improvement Act (CMIA) and to direct interaccount transfers; CMIA refunds and payments for purchased banking services from the treasury income account must occur before monthly earnings distributions and do not require appropriation. The section states no treasury account may be allocated earnings without the affirmative directive of the statute, and large lists of specific accounts and funds are identified to receive proportionate shares. The text in the extracted facts is incomplete in places. The name of "the department" that will administer the abortion savings program is not specified here, details on grant application procedures, award criteria, monitoring, or reporting are not provided, and portions of the reenacted/amended RCW 43.84.092 text and lists of accounts/funds are truncated in the provided excerpts. The act also contains specified effective dates and expirations for several sections tied to dates and to RCW 74.76.040, but the full related sections are not included in the extracted facts.

If enacted, health insurers that sell plans subject to RCW 48.14.020/0201 will face a new annual per-coverage-month assessment (higher in the first year, lower thereafter) that they are generally required to absorb rather than pass on to enrollees unless a regulator finds pass-through is needed to avert insolvency or serious consumer harm. That will increase carriers' annual costs and create new administrative and compliance duties for the insurance commissioner (filing statements, enforcing penalties, revoking authority for delinquencies), send revenue to a new “abortion savings account,” and fund grants intended to keep direct patient abortion care accessible; the administering department must direct most appropriated funds to grants and must protect identifying information of applicants, providers, and staff. The bill leaves out the department’s specific name and many details about how grants will be awarded and monitored, so the timing and amount of actual grant awards and administrative burdens remain uncertain. The act also consolidates investment earnings into a treasury income account that the state treasurer will distribute monthly, crediting the general fund except that many named accounts and agencies that deposit funds by agreement will receive proportionate shares based on average daily balances; the Office of Financial Management will handle federal CMIA transfers and may direct interaccount transfers. In practice this changes how investment earnings flow across numerous state funds, prioritizes CMIA refunds and payments for banking services before monthly distributions, and removes the need for separate appropriations for those CMIA-related refunds and banking payments. A long list of affected accounts and precise allocation mechanics are included but the excerpts are incomplete, and several sections of the act have staggered expirations and effective dates between mid-2028 and early 2029 or tied to RCW 74.76.040, creating timing uncertainty for implementation.