All Roll Calls
Yes: 198 • No: 43
WashingtonHB 14322025-2026 Regular SessionHouseWALLET
Improving access to appropriate mental health and substance use disorder services.
Sponsored By: Tarra Simmons (Democratic)
Signed by Governor
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 6 benefits, 0 costs, 0 mixed.
Broader coverage for mental health care
Beginning January 1, 2027, Washington plans covering medical and surgical care must cover mental health and substance use care. Costs and treatment limits must follow federal parity rules. Plans issued or renewed from that date cover outpatient, residential, partial hospital, inpatient care, and prescription drugs. Covered diagnoses include DSM categories available June 11, 2020, and ICD mental health and DC:0-5 early childhood categories available January 13, 2025; the commissioner can approve later versions. If a condition is covered in one benefit category, meaningful benefits must extend to every category covering medical or surgical care. This includes core treatments where required, and benefits even where no core treatment exists. Five older mental health coverage statutes are repealed January 1, 2027.
Fewer review barriers for initial counseling
Beginning January 1, 2027, carriers and plan managers cannot require review for an initial evaluation and up to six treatment visits. This covers a new outpatient mental health or substance use episode with a participating provider. The condition or diagnosis must be new, with no treatment by the same licensed profession during the past 90 days. The patient also cannot be in active treatment. These visits cannot be denied as medically unnecessary or inappropriate, or have coverage or payment denied retroactively. Existing plan treatment limits still apply, outpatient mental health procedures are excluded, and referral or prescription rules must follow parity requirements.
Patient needs guide mental health reviews
Beginning January 1, 2027, mental health and substance use reviews must follow accepted care standards and patients' clinical needs. Medical necessity cannot rest mainly on an insurer's financial interests or another person's convenience. Reviews of care intensity, placement, continued stays, transfers, and discharge must use relevant age-appropriate criteria from nonprofit professional groups. Carriers must approve care matching those criteria; extra criteria can approve care, but cannot deny it. When an adverse decision conflicts with the requested placement, patients and providers must receive full assessment details. These standards also apply to prior approval requests, drugs prescribed for these conditions, and outside reviews of coverage decisions. Carriers must keep written, evidence-based review criteria, keep drug criteria updated, and share specified review materials with participating providers on request.
Stronger protections against mental health exclusions
Beginning January 1, 2027, carriers cannot deny medically needed mental health or substance use care because a public program could cover it. This does not require duplicate coverage when that program has already approved and provided the benefit, unless another law requires coverage. Carriers also cannot use plan or provider contract terms that undermine the law's coverage protections. This ban covers both written terms and rules applied in practice.
Clearer insurance rules for mental health patients
Beginning January 1, 2027, after an adverse coverage decision, you can request federally required analyses comparing mental health and medical care restrictions. The carrier must provide them free within 30 days of your request. Carriers and plan managers must also post provider tiers online when approval rules differ among providers of the same profession and plan. The insurance commissioner can adopt implementing rules and require numerical data to check compliance with coverage parity requirements. The law's required funding was provided by June 30, 2025.
Shorter refund deadlines for mental health claims
Beginning January 1, 2027, carriers generally have six months after payment to seek refunds for mental health or substance use services. That is down from 24 months. When coordinating payments between plans, the deadline is nine months instead of 30 months. Existing exceptions remain, including fraud and certain claims involving another party's liability.
Sponsors & Cosponsors
Sponsor
Tarra Simmons
Democratic • House
Cosponsors
Alicia Rule
Democratic • House
Carolyn Eslick
Republican • House
Chris Stearns
Democratic • House
Gerry Pollet
Democratic • House
Joe Timmons
Democratic • House
Julia Reed
Democratic • House
Lauren Davis
Democratic • House
Nicole Macri
Democratic • House
Osman Salahuddin
Democratic • House
Roger Goodman
Democratic • House
Sharon Tomiko Santos
Democratic • House
Roll Call Votes
House vote • 4/22/2025
Final Passage as Amended by the Senate
Yes: 78 • No: 19 • Other: 1
Senate vote • 4/14/2025
3rd Reading & Final Passage as Amended by the Senate
Yes: 48 • No: 1
House vote • 3/11/2025
3rd Reading & Final Passage
Yes: 72 • No: 23 • Other: 3
Actions Timeline
Effective date 7/27/2025*.
5/12/2025HouseChapter 227, 2025 Laws.
5/12/2025HouseGovernor signed.
5/12/2025legislatureDelivered to Governor.
4/25/2025legislaturePresident signed.
4/24/2025legislatureSpeaker signed.
4/23/2025legislaturePassed final passage; yeas, 78; nays, 19; absent, 0; excused, 1.
4/22/2025HouseHouse concurred in Senate amendments.
4/22/2025HouseThird reading, passed; yeas, 48; nays, 1; absent, 0; excused, 0.
4/14/2025HouseRules suspended. Placed on Third Reading.
4/14/2025HouseCommittee amendment(s) adopted with no other amendments.
4/14/2025HousePlaced on second reading by Rules Committee.
4/9/2025HouseMinority; without recommendation.
4/8/2025HouseWM - Majority; do pass with amendment(s) by Health & Long-Term Care.
4/8/2025HousePassed to Rules Committee for second reading.
4/8/2025HouseReferred to Ways & Means.
3/29/2025HouseAnd refer to Ways & Means.
3/27/2025HouseMinority; do not pass.
3/27/2025HouseHLTC - Majority; do pass with amendment(s).
3/27/2025HouseFirst reading, referred to Health & Long-Term Care.
3/14/2025HouseThird reading, passed; yeas, 72; nays, 23; absent, 0; excused, 3.
3/11/2025HouseRules suspended. Placed on Third Reading.
3/11/2025HouseFloor amendment(s) adopted.
3/11/2025House2nd substitute bill substituted.
3/11/2025HouseRules Committee relieved of further consideration. Placed on second reading.
3/10/2025House
Bill Text
Session Law
5/15/2025
Bill as Passed Legislature
4/30/2025
Engrossed Second Substitute
3/12/2025
Second Substitute
3/3/2025
Substitute Bill
2/21/2025
Original Bill
1/21/2025
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