The Health Care Authority (HCA) serves as the state’s single Medicaid state agency and is the largest purchaser of health care in the state. We lead the effort on transforming health care through programs and initiatives that range from the administration of Apple Health (Medicaid) and behavioral health activities to developing models for value-based purchasing and health technology assessments. We use data to inform our decisions and work in collaboration with local communities to ensure that Washington residents have access to better health and better care at a lower cost.

See HCA's decision packages on the Office of Financial Management's website.

Go to OFM's Agency Budget Request page

About HCA’s legislative priorities

HCA faces unique challenges largely driven by the passage of H.R.1 in July 2025, along with required and shifting federal directives that impact every pillar of HCA’s work. These changes generate significant work in the years to come, requiring staffing and technology to ensure that as many Washingtonians as possible keep their health care coverage and that our state remains in compliance with federal regulations to avoid any fiscal consequences.

2026 legislative session

Our 2026 Agency Request Legislation and Supplemental Budget Decision Packages were primarily focused on responding to the significant policy changes at the federal level and investments that will support the agency’s core functions. Further, our requests also included critical investments that support the most pressing health care needs of our state with a focus on eradicating health disparities.

Learn about HCA's work during the 2026 legislative session.

View our session recap presentation.

Can an eligible SEBB employee waive medical to remain enrolled on someone else’s (i.e. spouse, SRDP or parent’s) COBRA coverage?: No, an employee cannot waive enrollment in medical to be on someone else’s COBRA medical coverage. An employee may waive enrollment in medical if they are enrolled in other employer-based group medical, a TRICARE plan, or Medicare Part A and B. "Employer-based group medical" is defined as group medical related to a current employment relationship and does not include COBRA coverage.

Can an eligible PEBB employee waive medical to remain enrolled on someone else’s (i.e. spouse, SRDP or parent’s) COBRA coverage?: No, an employee cannot waive enrollment in medical to be on someone else’s COBRA medical coverage. An employee may waive enrollment in medical if they are enrolled in other employer-based group medical, a TRICARE plan, or Medicare Part A and B. "Employer-based group medical" is defined as group medical related to a current employment relationship and does not include COBRA coverage.

Early Periodic Screening, Diagnosis and Treatment (EPSDT) Updates

Affected WACs

182-500-0030, 182-501-0050, 182-530-2100, 182-531-0100, 182-531-0150, 182-531-0250, 182-531-1600, 182-531-1675, 182-535-1050, 182-535-1079, 182-535-1100, 182-535A-0010, 182-535A-0040, 182-538-180, 182-544-0575, 182-552-0450, 182-554-800, 182-556-0200

Formally proposed

WSR 25-21-142

Effective 11/21/2025

Description

The Health Care Authority is updating the Early Periodic Screening, Diagnosis, and Treatment (EPSDT) rules across applicable agency programs. The revised language aligns with guidance from the Centers for Medicare & Medicaid (CMS) and will refer to the EPSDT Chapter (182-534 WAC), recently amended under WSR 25-13-048.