HB 1291 Washington House · 2025-2026 Regular Session

Concerning cost sharing for maternity services.

HB 1291 aims to reduce upfront costs for individuals receiving maternity services through their health plans in Washington State. Starting January 1, 2026, most health plans will no longer require enrollees to meet their deductible before covering in-network delivery services, such as vaginal or C-section births. Any out-of-pocket costs paid for these services will still count towards the enrollee's total deductible. For health plans linked to Health Savings Accounts, deductibles for delivery services will be set at the minimum level required to maintain the HSA's tax-exempt status.

Issues: ✓ Healthcare

Bill status passed 3 of 5 stages cleared

Introduction

Jan 2026

Committee Review

Jan 2026

House Passage

Mar 2025

Senate Passage

Governor

Introduced Jan 12, 2026 Last action Jan 12, 2026

Maddy AI version diff · 2 comparisons

What changed between versions

Substitute Bill → Engrossed Substitute Bill · 3 edits · Mar 3, 2025

MINOR

The bill was updated to its final version, 'Engrossed Substitute Bill,' and expanded its legislative summary to include the creation of a new section. The core policy regarding maternity care was modified to replace specific billing codes with the broader term 'labor and delivery services,' ensuring the deductible exemption applies to the entire service category rather than just specific billing items. A new Section 3 was added to explicitly authorize the insurance commissioner to adopt rules necessary to implement the act.

Scope change

The bill's scope was broadened in its description to include the authority for rulemaking, and the specific application of the maternity care rule was generalized from specific billing codes to the broader category of labor and delivery services.

ENFORCEMENT

Added a new Section 3 granting the insurance commissioner the authority to adopt rules needed to implement the act.

DEFINITION

Changed the requirement from covering specific 'global maternity care billing codes' to covering 'labor and delivery services' generally.

TECHNICAL

Updated the bill title and act summary to reflect the addition of the new rulemaking section.

Floor votes · House Mar 3, 2025

How they voted

57–40

Passed · 3 other

Total votes 100

Mar 3, 2025

D Democratic61

57 Yea 1 Nay 3

93% Yea

R Republican39

39 Nay

100% Nay

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Jan 12, 2026

Committee

Referred to Health Care & Wellness.

lower

Jan 12, 2026

Lower · Passed

Rules Committee relieved of further consideration.

lower

Jan 12, 2026

Introduced

By resolution, reintroduced and retained in present status.

lower

Mar 27, 2025

Upper · Passed

Minority; without recommendation.

upper

Mar 27, 2025

Upper · Passed

Minority; do not pass.

upper

Mar 27, 2025

Upper · Passed

HLTC - Majority; do pass with amendment(s).

upper

Mar 27, 2025

Upper · Passed

Executive action taken in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

Mar 21, 2025

Upper · Passed

Executive session scheduled, but no action was taken in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

Mar 20, 2025

Upper · Passed

Public hearing in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

Mar 3, 2025

Lower · Passed

Floor amendment(s) adopted.

lower

Feb 11, 2025

Committee

Referred to Rules 2 Review.

lower

Feb 7, 2025

Lower · Passed

Minority; without recommendation.

lower

Feb 7, 2025

Lower · Passed

Minority; do not pass.

lower

Feb 7, 2025

Lower · Passed

Executive action taken in the House Committee on Health Care & Wellness at 8:00 AM.

lower

Jan 28, 2025

Lower · Passed

Public hearing in the House Committee on Health Care & Wellness at 1:30 PM.

lower

1 primary · 10 co-sponsors