HB 2196 Washington House · 2025-2026 Regular Session

Expanding access to PANDAS PANS treatment.

This bill requires most health insurance plans (excluding public employee plans) to cover intravenous immunoglobulin therapy for children diagnosed with PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) or PANS (pediatric acute-onset neuropsychiatric syndrome) starting January 2027. It mandates coverage for three initial monthly treatment courses and ongoing care as medically necessary, after less intensive treatments fail or aren't tolerated. The law prohibits insurers from denying coverage based on prior treatment history, diagnostic name changes, requiring ineffective symptom-only therapies first, or restricting coverage inconsistent with medical guidelines. It also ensures coverage for out-of-state treatment when local care isn't available.
Bill status passed 3 of 5 stages cleared
Introduction
Dec 2025
Committee Review
Feb 2026
House Passage
Feb 2026
Senate Passage
Governor
Introduced Dec 24, 2025 Last action Mar 12, 2026
Maddy AI version diff · 2 comparisons

What changed between versions

Substitute Bill Engrossed Substitute Bill · 2 edits · Feb 16, 2026
MINOR
The bill was amended to clarify that the new treatment coverage requirements apply to 'nongrandfathered group health plans' rather than all plans other than public employee plans. Additionally, a new exemption was added to explicitly exclude small group health plans from these requirements. These changes narrow the scope of the mandate to ensure it applies only to larger, non-grandfathered private insurance plans while protecting smaller insurers from the new obligations.
Scope change
The bill's applicability was narrowed from all private health plans (excluding public employee plans) to specifically 'nongrandfathered group health plans,' and small group health plans were added as an explicit exemption.
ELIGIBILITY

Changed the definition of covered plans from 'health plans other than health plans offered to public employees' to 'nongrandfathered group health plans' to clarify which private insurance policies must comply.

Added a new subsection explicitly stating that the coverage requirements do not apply to small group health plans.

Floor votes · House Feb 16, 2026

How they voted

8513
Passed · 2 other
Total votes 100
Feb 16, 2026
D Democratic61
60 Yea 1
98% Yea
R Republican39
25 Yea 13 Nay 1
64% Yea
Vote distribution
All Yea All Nay Mixed No data
Full legislative history

Actions timeline

Total actions
15
Key actions
5
Committee
5
Feb 16, 2026
Lower · Passed
Floor amendment(s) adopted.
lower
Feb 4, 2026
Committee
Referred to Rules 2 Review.
lower
Feb 3, 2026
Lower · Passed
Minority; without recommendation.
lower
Feb 3, 2026
Lower · Passed
Minority; do not pass.
lower
Feb 3, 2026
Lower · Passed
Executive action taken in the House Committee on Health Care & Wellness at 1:30 PM.
lower
Jan 16, 2026
Lower · Passed
Public hearing in the House Committee on Health Care & Wellness at 8:00 AM.
lower
1 primary · 10 co-sponsors

Sponsors