This bill adds a new section to chapter 48.43 RCW that requires health carriers to cover all FDA-approved HIV antiviral drugs without prior authorization, step therapy, or other utilization management protocols for health plans issued or renewed on or after January 1, 2027. It creates a limited exception: if one or more therapeutically equivalent products are FDA-approved, the plan is not required to cover every equivalent product without utilization management, provided that at least one therapeutically equivalent version is covered without prior authorization, step therapy, or other utilization management protocols. The bill also reenacts and amends RCW 41.05.017 to make each health plan that provides medical insurance under that chapter subject to a specified list of RCW sections, including the new section in chapter 48.43 and chapter 48.49 RCW. Affected entities named in the text include health carriers and health plans issued or renewed on or after January 1, 2027, and plans providing medical insurance under RCW chapter 41.05. This is a statutory change that creates a new coverage requirement and restricts utilization management procedures for specified drugs; it is a procedural change to insurance coverage rules rather than a criminal or penalty provision. The extracted text does not include definitions for key terms (for example, “therapeutic equivalents,” “prior authorization,” or “utilization management protocols”), nor does it include implementation details, enforcement mechanisms, or penalties. The bill’s legislative history in the extracted facts shows it was read in the Senate on 01/29/26, passed the Senate on 02/10/26 (Yeas 48, Nays 0), and passed the House on 03/03/26 (Yeas 93, Nays 1).

If enacted, beginning with plans issued or renewed January 1, 2027, insurers and other health carriers will no longer be allowed to require prior authorization, step therapy, or similar utilization controls for FDA‑approved HIV antiviral drugs; when interchangeable versions exist, the carrier must at least offer one such version without those controls. The change is written to apply not only to private plans but also to medical plans created under RCW 41.05, so state and other plans in that chapter will be brought under the same requirement. The groups most affected are health carriers and the administrators of plans under RCW 41.05, who will lose a common tool for managing specialty drug use and likely face higher pharmacy spending and administrative adjustments. Carriers may try to offset costs by renegotiating drug prices, adjusting premiums, or changing coverage in other areas. Key implementation details are missing here — for example how “therapeutic equivalents” are identified, how compliance will be enforced, and whether there are penalties — so the exact budgetary and operational effects on carriers and covered groups are uncertain.