All Roll Calls
Yes: 121 • No: 25
WashingtonHB 16692025-2026 Regular SessionHouseWALLET
Concerning coverage requirements for prosthetic limbs and custom orthotic braces.
Sponsored By: Monica Jurado Stonier (Democratic)
Became Law
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 1 costs, 0 mixed.
Covered repairs and replacements for devices
Starting January 1, 2026, required coverage also includes device materials and parts, related services, instruction on use, and reasonable repair or replacement. Plans must cover a replacement (ignoring useful‑life limits) when medically necessary because your condition changed, the device is irreparably damaged, or a repair would cost more than 60% of a replacement. If a device or part is under three years old, the plan may ask your prescriber to confirm the medical need for replacement.
Employer plans must cover prosthetics and braces
Beginning January 1, 2026, large- and small‑group employer health plans issued or renewed on or after that date must cover one or more prostheses per limb and custom orthotic braces per limb when medically necessary. Coverage applies when you need the device to do daily activities, essential job tasks, or to perform physical activities to maximize limb function. Plans may not deny a prosthetic or custom brace for a person with a disability if the plan would cover a similar medical or surgical treatment for someone without a disability. A prosthetic limb replaces a missing limb. A custom orthotic brace is made or fitted for one person to support or correct a muscle or bone problem.
Medicare-level pay for prosthetics and braces
Beginning January 1, 2026, insurers must pay at least what Medicare pays for covered prosthetic limbs, custom orthotic braces, and related services. This helps keep providers available and reduces payment disputes.
Some plans are excluded from coverage
This law does not apply to individual‑market plans or to public‑employee large‑group plans under chapter 41.05 RCW. People in those plans do not get the new required coverage starting January 1, 2026.
Prior authorization rules and written denials
Insurers may use their normal prior authorization for these devices. If they deny coverage, they must send you a written notice explaining that it was not medically necessary. This applies starting January 1, 2026.
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Sponsors & Cosponsors
Sponsor
Monica Jurado Stonier
Democratic • House
Cosponsors
Beth Doglio
Democratic • House
Clyde Shavers
Democratic • House
Debra Lekanoff
Democratic • House
Greg Nance
Democratic • House
Julia Reed
Democratic • House
Lauren Davis
Democratic • House
Lisa Parshley
Democratic • House
Liz Berry
Democratic • House
Michelle Valdez
Republican • House
Sam Low
Republican • House
Roll Call Votes
Senate vote • 4/10/2025
3rd Reading & Final Passage
Yes: 41 • No: 8
House vote • 3/12/2025
3rd Reading & Final Passage
Yes: 80 • No: 17 • Other: 1
Actions Timeline
Effective date 7/27/2025.
4/21/2025HouseChapter 96, 2025 Laws.
4/21/2025HouseGovernor signed.
4/21/2025legislatureDelivered to Governor.
4/16/2025legislaturePresident signed.
4/14/2025legislatureSpeaker signed.
4/11/2025legislatureThird reading, passed; yeas, 41; nays, 8; absent, 0; excused, 0.
4/10/2025HouseRules suspended. Placed on Third Reading.
4/10/2025HousePlaced on second reading by Rules Committee.
4/7/2025HousePassed to Rules Committee for second reading.
3/24/2025HouseMinority; do not pass.
3/21/2025HouseHLTC - Majority; do pass.
3/21/2025HouseFirst reading, referred to Health & Long-Term Care.
3/14/2025HouseThird reading, passed; yeas, 80; nays, 17; absent, 0; excused, 1.
3/12/2025HouseRules suspended. Placed on Third Reading.
3/12/2025House1st substitute bill substituted.
3/12/2025HouseRules Committee relieved of further consideration. Placed on second reading.
3/11/2025HouseMinority; do not pass.
2/21/2025HouseHCW - Majority; 1st substitute bill be substituted, do pass.
2/21/2025HouseReferred to Rules 2 Review.
2/21/2025HouseHCW - Executive action taken by committee.
2/21/2025HouseFirst reading, referred to Health Care & Wellness.
1/28/2025HouseIntroduced
1/28/2025House
Bill Text
Session Law
4/22/2025
Bill as Passed Legislature
4/12/2025
Substitute Bill
2/21/2025
Original Bill
1/28/2025
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