HCA plans two health care coverage procurement efforts

Tue, 05/31/2022

The Health Care Authority (HCA) is planning two major health care coverage procurement efforts to further Governor Jay Inslee’s and the Legislature’s aim to cover all individuals in Washington:

  • The Legislature authorized HCA to develop a new coverage product for low-income uninsured individuals in Washington who do not qualify for Apple Health (Medicaid) or other similar coverage. We intend to release a request for proposals by the end of this year for potential bidders from one or more of our managed care plans to offer a separate insurance plan similar to the Medicaid managed care plans offered today. To meet this short timeline, it is critical we limit this procurement to our current contractors and take the following year of 2023 to review and select the contractor or contractors and ensure readiness. Pending final legislative funding, we anticipate coverage starting January 1, 2024. 
  • Coinciding with the new program discussed above, we also plan to reprocure Apple Health managed care contracts, with a projected implementation date of January 1, 2025. We need a longer timeframe to develop the program policy goals and ensure readiness of selected plans because we intend to open this procurement to all interested insurance carriers, in addition to our current plans. We last procured Apple Health managed care contracts in 2012, so it is time to do it again. 

The goals of these procurements are to ensure high value, equitable access to whole-person, quality, and cost-effective health care for the more than 2 million Washington residents we serve today and for those we look forward to covering in the future. We will work to align these procurements with each other and with our Medicaid Transformation Project waiver renewal work and other coverage from the Health Benefit Exchange and Cascade Care

Stay informed

Sign up for Apple Health (Medicaid) programs and eligibility general information and updates. HCA is committed to listening to input from the individuals we serve as we design these procurement processes. If you have questions, please submit via email.  We will provide further information on hca.wa.gov as these projects progress.