AN ACT Relating to requiring guaranteed issue of medicare supplemental coverage to an individual who voluntarily disenrolls from a medicare advantage plan and enrolls in medicare parts A and B;
Summary
HB1603 would require guaranteed issue of Medicare supplemental coverage, commonly known as Medigap, for certain individuals who leave a Medicare Advantage plan and enroll in Medicare Parts A and B. The bill amends Washington law governing Medicare supplement policies so that insurers generally may not deny, condition, or price coverage based on health status, claims experience, medical condition, or preexisting conditions for eligible applicants. It also expands the circumstances under which a person has a right to buy a Medigap policy, including when coverage ends because of plan termination, involuntary disenrollment, certain changes in residence or eligibility, and when a person voluntarily disenrolls from Medicare Advantage and returns to Original Medicare.
Impact
The bill would significantly revise state insurance statutes governing Medicare supplement policies by adding new guaranteed-issue rights and related notice requirements for insurers, Medicare Advantage organizations, and plan administrators. It would require issuers to accept applications within specified time windows after disenrollment or loss of coverage, prohibit underwriting discrimination for eligible persons, and preserve access to standardized Medigap plans, including plans with high-deductible options. The measure would affect Medicare beneficiaries, insurers offering supplemental policies, Medicare Advantage enrollees, and entities administering employer welfare, PACE, and other Medicare-related coverage arrangements.
Sentiment
Based on the bill caption and the absence of recorded committee testimony or votes in the provided materials, the overall sentiment appears supportive of expanding consumer access to supplemental Medicare coverage. The bill is framed as a beneficiary-protection measure that helps people who leave Medicare Advantage avoid gaps in coverage and obtain Medigap policies without medical underwriting barriers. No contrary positions are documented in the supplied record.
Contention
The main policy tension is between consumer access and insurer underwriting flexibility. Supporters would likely favor guaranteed issue and protections for people transitioning out of Medicare Advantage, while insurers may be concerned about being required to accept applicants outside normal enrollment periods and about limits on pricing based on health status. Another potential point of contention is the breadth of qualifying events and the administrative burden of notice and timing requirements for plans and issuers, though no specific objections are recorded in the provided materials.
AN ACT Relating to the reprocurement of medical assistance services, including the realignment of behavioral health crisis services for medicaid enrollees;
Guaranteed issuance of Medicare supplement policies for enrollees of a Medicare supplement policy that is involuntarily terminated or issued by an insolvent issuer expanded.
Require the Department of Health and Human Services to file a state plan amendment for coverage of long-acting injectable and extended-release medications for certain individuals