Rulemaking for Mandatory Hospital Participation in Public Option Plans

September 29, 2021

As WSHA previously reported, Senate Bill 5377 enacted during the 2021 legislative session made key modifications to public option health plans (also known as “Cascade Select”). WSHA heavily negotiated the bill with legislators in 2021. The bill also included a provision that grants the Health Care Authority (HCA) the authority to adopt rules to enforce the hospital participation mandate. The HCA has scheduled a webinar on October 4 from 1:00 – 2:00 PM to discuss rules around the hospital participation mandate. The HCA communication with webinar connection link is here.  We anticipate the agency will discuss both the definition of an “offer” from a public option health plan and potential enforcement mechanisms. WSHA will engage members and participate in the rulemaking process. We also encourage members to participate in the webinar.

SB 5377 included a provision mandating hospital participation in at least one public option plan upon receiving an offer to contract. This provision takes effect in 2022 or any subsequent year there are any counties where a public option health plan is not available to consumers (commonly referred to as bare counties). The Washington Health Benefits Exchange recently certified plans that will be offered on the Exchange in 2022, and there will be fourteen bare counties, so the mandatory participation provision will take effect for plan year 2023 with contracting arrangements occurring in 2022. Please review WSHA’s bulletin from June 2021 for more information.  (Ashlen Strong,


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