Washington Require Health Insurance Companies Cover Medically Necessary Services Initiative (2026)
| Washington Require Health Insurance Companies Cover Medically Necessary Services Initiative | |
|---|---|
 | |
| Election date November 3, 2026 | |
| Topic Private health insurance | |
| Status Cleared for signature gathering | |
| Type State statute | Origin Citizens |
The Washington Require Health Insurance Companies Cover Medically Necessary Services Initiative may be on the ballot in Washington as an indirect initiated state statute on November 3, 2026.
The initiative would require health insurance companies to cover all services and medications for patients if a licensed care provider determines the treatments are medically necessary, before the company challenges the necessity of such treatments. The initiative would also relieve policyholders from liability for any amount beyond the deductible and copayments in their plan for treatments received from an in-network provider.[1]
Text of measure
Ballot title
The official ballot title is as follows:[2]
| “ |
Initiative Measure No. IL26-282 concerns health insurance coverage of medically-necessary care. This measure would limit claim denials and medical-appropriateness review for care determined by licensed health care providers to be medically-necessary and relieve policyholders from liability for amounts beyond cost-sharing applicable for in-network providers. Should this measure be enacted into law? Yes [ ] No [ ][3] |
” |
Ballot summary
The official ballot measure summary is as follows:[2]
| “ | This measure would require health insurance carriers and others administering health insurance claims to cover all services and medications a licensed health care provider determines are medically-necessary before challenging medical necessity, and to hold policyholders harmless for amounts beyond copayments and deductibles applicable to in-network providers. It would establish mandatory arbitration for disputes between providers and carriers; provide for administration and enforcement by the insurance commissioner and department of health; and define various terms.[3] | ” |
Full text
The full text of the measure is available here.
Path to the ballot
Process in Washington
An indirect initiated state statute is a citizen-initiated ballot measure that amends state statute. There are nine (9) states that allow citizens to initiate indirect state statutes.
While a direct initiative is placed on the ballot once supporters file the required number of valid signatures, an indirect initiative is first presented to the state legislature. Legislators have a certain number of days, depending on the state, to adopt the initiative into law. Should legislators take no action or reject the initiative, the initiative is put on the ballot for voters to decide.
In Washington, the number of signatures required for an indirect initiated state statute, called an Initiative to the Legislature (ITL), is equal to 8% of the votes cast in the last gubernatorial election. Signatures for indirect initiatives are due at least 10 days prior to the beginning of the legislative session in the year of the targeted election.
In Washington, the Legislature has three options regarding Initiatives to the Legislature:
- (1) The Legislature can adopt an Initiative to the Legislature, in which case the initiative is enacted into law without a vote of electors;
- (2) The Legislature can reject or not act on the initiative, in which case the initiative is placed on the ballot at the next state general election; or
- (3) The Legislature can approve an alternative to the proposed initiative, in which case both the original proposal and the legislative alternative are placed on the ballot at the next state general election.
If an indirect initiative goes to the ballot, a simple majority vote is required for approval.
The requirements to get an Initiative to the Legislature certified for the 2026 ballot:
- Signatures: 308,911 valid signatures
- Deadline: January 2, 2026
Stages of the initiative
The following is the timeline of the initiative:[4]
- July 10, 2025: Devlon Gilcrease of Auburn, WA, submitted the initiative petition to the Washington Secretary of State for review.
- July 29, 2025: The Secretary of State assigned the initiative a ballot title, ballot summary, and serial number (IL26-282). The initiative was approved to begin gathering signatures.
External links
See also
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Footnotes
- ↑ Washington Secretary of State - Elections, "Initiative Measure No. IL26-282," accessed July 30, 2025
- ↑ 2.0 2.1 Secretary of State - Elections, "IL26-282 Ballot Title Letter," accessed July 30, 2025
- ↑ 3.0 3.1 Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ Washington Secretary of State - Elections, "Proposed Initiatives to the Legislature - 2025," accessed July 30, 2025
