wa-law.org > bill > 2025-26 > HB 2300 > Original Bill
The legislature finds that:
Recent federal changes to the medicaid program will affect all sectors of Washington's health care system. With reduced federal moneys, there will be pressure for the state to restore funds to maintain critical health services and program eligibility. By seeking reimbursement from employers whose workers are enrolled in medical assistance programs, the state can preserve the coverage and services available to Washingtonians who rely on publicly financed health care; and
An important part of a comprehensive approach to providing appropriate health care for all Washington citizens involves participation by employers in providing access to health care services for their workers and their families. While most Washington citizens obtain health care services through their employment or the employment of a family member, some employers with adequate resources fail to offer affordable access to health care services to their workers in Washington state. This creates inappropriate competitive advantages for those employers and greatly increases the likelihood that their workers will not have access to affordable health care services or will receive health care services through publicly funded health care programs.
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It is the intent of the legislature to establish, as part of its comprehensive approach to preserving access to appropriate health care services, a mechanism to reimburse the state for its costs of providing access to appropriate health care services to Washington workers. Employer participation in this comprehensive approach allows the state to improve its financing of public health care programs and prioritize those resources on populations not served through employment. It also reduces the burden on taxpayers and the public health care system, and protects the health, safety, and well-being of all the state's residents.
In establishing this program, it is not the intent of the legislature to influence the establishment, content, or administration of employee benefit plans. The legislature is neutral regarding whether employers choose to provide access to affordable health care coverage for their workers or pay an assessment to reimburse the state's costs for health care services for their workers.
The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.
"Assessment value" means an amount equal to the state portion of the per capita cost of providing health benefits under medical assistance programs under chapter 74.09 RCW for a calendar quarter.
"Authority" means the health care authority.
"Department" means the department of employment security.
"Employer" means an "employer" as defined in RCW 49.46.010 who employed a total of 500 or more workers at any and all locations in Washington in the completed calendar quarter for which a report is made in section 3 of this act. "Employer" includes a franchisor that has franchisees in Washington state that collectively employ a total of 500 or more workers. "Employer" does not include:
An employer that makes payments for the purpose of providing or reimbursing the cost of health care services, as defined in RCW 48.43.005, for all of its workers who are enrolled in medical assistance programs under chapter 74.09 RCW; or
A seasonal employer.
"Seasonal employer" means an employer in an industry, other than the construction industry, that the agencies determine, upon application by the employer:
Customarily operates only during regularly recurring periods of 26 weeks or less in any 52 consecutive week period; or
Customarily employs 50 percent or more of its workers for regularly recurring periods of 26 weeks or less within a period of 52 consecutive weeks.
"Worker" means any individual subject to the community engagement requirements under 42 U.S.C. Sec. 1396a who is either employed or independently contracted to work 80 or more hours per month for an employer during a given calendar quarter, but does not include:
A worker employed by the employer for fewer than 90 days;
During the first 12 months of employment with the employer, a worker who was employed through the job placement activities of the department of social and health services, the employment security department, or organizations contracting with these agencies to provide job placement services;
A worker at a franchisor's franchisees. Such workers are employed by the franchisor;
A worker who is receiving disability benefits under the federal old-age, survivors, and disability insurance act;
The federal government;
The state, state institutions, and state agencies; and
Any unit of local government including, but not limited to, a county, city, town, municipal corporation, quasi-municipal corporation, or political subdivision.
The apple health corporate assessment program is established through a partnership between the authority and the department for the purpose of requiring certain employers of medical assistance program enrollees to reimburse the state for the cost of purchasing health care coverage for its workers. Funds received through the program shall be deposited in the apple health corporate assessment account under section 6 of this act.
Beginning with the calendar quarter ending June 30, 2027:
Within 30 days of the completion of a calendar quarter, the authority and department shall jointly determine which workers employed by employers during the immediately preceding calendar quarter are under 65 years old and enrolled in a medical assistance program under chapter 74.09 RCW during the calendar quarter;
Upon making the determination in (a) of this subsection, the department shall calculate the total amount of the assessment value for each employer. The total amount shall be the assessment value, as established and published by the authority, multiplied by the number of workers employed by the employer who were enrolled in a medical assistance program under chapter 74.09 RCW for any period of time during the calendar quarter;
Within 60 days of completion of a calendar quarter, the department shall notify each employer that has workers enrolled in medical assistance programs under chapter 74.09 RCW of the total amount of the assessment value for which the employer is responsible. The department may not disclose the names of workers identified, but shall provide the employer with the number of workers identified as enrolled. The notice shall inform the employer that the employer shall pay the total amount of the assessment value specified in the notice for each worker under age 65 who is enrolled in medical assistance programs under chapter 74.09 RCW.
Within 30 days of receiving the notice under subsection (2)(c) of this section, the employer shall pay the full amount of the assessment required under subsection (2)(c) of this section. All payments for a particular quarter must be made within three calendar quarters of the notification from the authority for that calendar quarter.
An employer that fails, within the time period required by subsection (3) of this section, to pay the assessment provided for in subsection (2) of this section is subject to:
A civil penalty of five percent of the assessment due for the first month or part thereof, 10 percent of the assessment due for the second month or part thereof, and 20 percent of the assessment due for the third month or part thereof;
An interest penalty of one percent per month on the assessment due; and
The suspension of eligibility for any tax preference under Title 82 or 84 RCW and any state funds for up to five years. The department shall notify the department of revenue and the department of enterprise services of any employer that has had its eligibility suspended under this subsection.
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An employer may request a hearing by filing a request with the department within 30 days after the date on which the employer received the notice required in subsection (2)(b) of this section. The hearing must be conducted in accordance with chapter 34.05 RCW.
If any employer fails to pay an assessment after it has become a final and unappealable order, or after the court has entered final judgment in favor of the department, the department shall refer the matter to the state attorney general, who shall recover the amount assessed, and any penalties and interest, by action in the superior court. In such an action, the validity and appropriateness of the final order imposing the penalty is not subject to review.
An enrollee or prospective enrollee has a right to be free of interference, coercion, discrimination, or reprisal from an employer for exercising their rights under chapter 74.09 RCW. The remedies provided in this section are not exclusive, and an enrollee or prospective enrollee has all other rights and remedies afforded by law.
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An employer may not discriminate in any manner against a worker or job applicant because the person has:
Made inquiries about enrollment or the person's rights to enrollment in medical assistance programs under chapter 74.09 RCW or assisted another in regard to rights to such enrollment;
Applied for or enrolled in, or communicated an intent to enroll in, medical assistance programs under chapter 74.09 RCW, caused any proceeding related to such enrollment to be instituted, or testified in any proceeding so commenced; or
Cooperated with the authority with respect to becoming enrolled in medical assistance programs under chapter 74.09 RCW or for purposes of section 3 of this act.
Any discrimination or attempt to discriminate against a worker within 90 days after notification of the employer under section 3 of this act that the employer has workers enrolled in medical assistance programs under chapter 74.09 RCW establishes a rebuttable presumption that such action was in violation of this section.
Persons who believe that they have been discriminated against in violation of this section:
May, within six months after the alleged act of discrimination, file a complaint with the human rights commission alleging discrimination. Upon receipt of such complaint, the human rights commission shall cause an investigation to be made as the commission deems appropriate. Within 60 days after the receipt of a complaint filed under this section, the human rights commission shall notify the complainant of the determination. If, after such investigation, the human rights commission determines that this section has been violated, the commission shall bring an action in the superior court of the county in which the violation is alleged to have occurred. If the human rights commission determines that this section has not been violated, the worker may institute the action on the worker's own behalf as provided in (b) of this subsection, but this subsection does not require a complainant to file a complaint with the human rights commission before pursuing remedies under (b) of this subsection; and
Has a civil cause of action for damages against the employer.
In any action brought under this section, the court shall award a prevailing plaintiff costs, including expert witness costs, and reasonable attorneys' fees and actual damages, or statutory damages of $5,000, whichever is greater, to be awarded to the aggrieved worker or job applicant. The court has jurisdiction, for cause shown, to restrain violations of this section and to order all appropriate relief including reinstatement of a worker, or hiring of a job applicant, with back pay.
For the purposes of this section, "discrimination" includes, but is not limited to:
Refusal to employ, reemploy, or promote;
Discharge from employment or demotion or suspension;
Reduction in hours of work, compensation, or other adverse changes in the conditions of employment; and
Involuntary transfer to another position or other duties.
The authority and the department each have distinct responsibilities, as well as collaborative functions, in the implementation and administration of the apple health corporate assessment program. The authority and the department shall collaborate as necessary to realize program efficiencies in the operation of the program.
The authority shall:
Determine the assessment value each calendar quarter and publish the assessment value; and
Adopt rules necessary to implement this chapter.
The department shall:
Notify each employer of the amount of its assessment obligation each quarter;
Calculate the amount of the assessment value for each employer;
Collect the assessment amount and any applicable civil penalty or interest penalty from each employer;
Deposit assessments, civil penalties, and interest penalties collected under this chapter into the apple health corporate assessment account under section 6 of this act; and
Perform investigations to determine the compliance of the payment of assessments by employers and impose civil penalties and interest penalties on employers that are noncompliant with the requirements of this chapter.
The authority and the department shall collaborate to:
Adopt a procedure to determine which workers are enrolled in a medical assistance program under chapter 74.09 RCW during a given calendar year; and
Adopt data-sharing agreements as necessary to perform their functions under this act.
The apple health corporate assessment account is created in the state treasury. All receipts from the payment of assessments, civil penalties, and interest penalties by employers must be deposited into the account. Moneys in the account may be spent only after appropriation. Expenditures from the account may only be used for reimbursing the authority for the cost of purchasing health care services, such as physical health services, behavioral health services, and long-term services and supports, including home and community-based services, for enrollees in medical assistance programs under chapter 74.09 RCW or other health safety net programs.
Any person claiming to be aggrieved by a violation of section 4 of this act may file a complaint with the commission. The commission shall promptly investigate and take other appropriate action as provided in section 4 of this act.
The health care authority shall, by November 15th of each year, report to the legislature:
The number of medical assistance recipients who: (i) Upon enrollment or recertification had reported being employed, and beginning with the 2008 report, the month and year they reported being hired; or (ii) upon enrollment or recertification had reported being the dependent of someone who was employed, and beginning with the 2008 report, the month and year they reported the employed person was hired. For recipients identified under (a)(i) and (ii) of this subsection, the authority shall report the basis for their medical assistance eligibility, including but not limited to family medical coverage, transitional medical assistance, children's medical coverage, aged coverage, or coverage for individuals with disabilities; member months; and the total cost to the state for these recipients, expressed as general fund‑state and general fund‑federal dollars. Beginning with the 2027 report, the report must include a list of the employers that are subject to the payment of an assessment under section 3(3) of this act and which of those employers are subject to the penalties in section 3(4) of this act for noncompliance with section 3(3) of this act. The information shall be reported by employer size for employers having more than 50 employees as recipients or with dependents as recipients. This information shall be provided for the preceding January and June of that year.
The following aggregated information: (i) The number of employees who are recipients or with dependents as recipients by private and governmental employers; (ii) the number of employees who are recipients or with dependents as recipients by employer size for employers with 50 or fewer employees, 51 to 100 employees, 101 to 1,000 employees, 1,001 to 5,000 employees and more than 5,000 employees; and (iii) the number of employees who are recipients or with dependents as recipients by industry type.
For each aggregated classification, the report will include the number of hours worked, the number of department of social and health services covered lives, and the total cost to the state for these recipients. This information shall be for each quarter of the preceding year.
If any part of this act is found to be in conflict with federal requirements that are a prescribed condition to the allocation of federal funds to the state, the conflicting part of this act is inoperative solely to the extent of the conflict and with respect to the agencies directly affected, and this finding does not affect the operation of the remainder of this act in its application to the agencies concerned. Rules adopted under this act must meet federal requirements that are a necessary condition to the receipt of federal funds by the state.
If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected.
This act may be known and cited as the apple health corporate assessment act.