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Wash State Health Care Authority

RCW 41.05

The Washington State Health Care Authority brings together the three largest purchasers of health care in state government – the Public Employees Benefits Board program, the Apple Health medical assistance program and the Community Behavioral Health program. The Public Employees Benefits Board program assures access to quality and affordable health care coverage for more than 350,000 public employees, retirees and others authorized by the Legislature; the Apple Health and Community Behavioral Health programs provide quality medical and behavioral health care with federal matching for more than 1.2 million low-income Washington residents. The Health Care Authority is a resource for both public and private health care, bending the cost curve to keep the state’s medical per-capita inflation rate below the national trend while maintaining administrative expenses around 3 percent of its annual budget. The Health Care Authority advises other employers on health care purchasing issues, strengthens health care policy formulation, and enhances the quality of health care delivery and primary care access in Washington state. Beginning in calendar year 2020, the Health Care Authority will administer the School Employees Benefits Board program, which will provide quality, cost-effective health care coverage for employees in Washington’s K-12 school districts, educational service districts and charter schools.

Agency Mission

The Health Care Authority provides high-quality health care through innovative health policies and purchasing strategies.
Request 26,761,911,000
Net change from current biennium 886,169,000 Increase
Percent change from current biennium 3.4% Increase

Operating Budget: Summary

Appropriated Funds

2021-23 Appropriations Appropriated Funds Expenditures
Amount Estimated Balance   2019-21 Actual 2021-23 Estimated 2023-25 Proposed
(65,181,000) General Fund - 65,181,000 51,580,000
16,875,673,359 70,889,359 General Fund - Federal 15,116,803,150 16,804,784,000 16,248,613,000
190,600,000 190,600,000 Coronavirus St Fiscal Recovery Fund - Federal
503,565,000 General Fund - Private/Local 268,114,472 503,565,000 914,631,000
100,000 100,000 Problem Gambling Account - Private/Local 100,000
Industrial Insurance Premium Refund - Nonappropriated 8,167
(2,063,000) Flexible Spending Admin Account - Nonappropriated 1,984,310 2,063,000 2,075,000
(62,000) Prescription Drug Consortium Acct - Nonappropriated 62,000 62,000 62,000
Salary Reduction Account - Nonappropriated 39,616,327
(523,155,000) Basic Health Plan Trust Account - Nonappropriated 477,765,000 523,155,000 536,258,000
(20,085,000) Indian Health Improvement Rein Acct - Nonappropriated 232,682 20,085,000 1,416,000
(13,684,000) Uniform Dental Plan Benefits Admin - Nonappropriated 12,255,114 13,684,000 15,794,000
(138,599,000) Uniform Medical Plan Benefits Acct - Nonappropriated 123,970,744 138,599,000 140,413,000
Info Tech Invest Rev Acct - Nonappropriated 1,942,000
(1,250,000) SEBB Flex Spend Dep Care Admin Acct - Nonappropriated 675,227 1,250,000 1,263,000
(10,746,000) SEBB Dental Benefits Admin Acct - Nonappropriated 6,949,564 10,746,000 12,039,000
School Employees' Insurance Account - Nonappropriated 2,473,749,966 16,513,000
(43,581,000) SEBB Medical Benefits Admin Acct - Nonappropriated 28,643,143 43,581,000 55,020,000
Public Employees/Retirees Insurance - Nonappropriated 4,824,001,991 260,000
SEBB Salary Reduction Account - Nonappropriated 22,638,507
6,686,418,000 450,000 General Fund - State 5,571,316,287 6,685,968,000 7,484,173,000
15,086,000 Emer Med Ser/Trauma Care Sys Trust - State 15,086,000 15,086,000 15,092,000
21,988,000 Criminal Justice Treatment Account - State 16,973,742 21,988,000 22,003,000
Disaster Response Account - State 4,500,000
Education Legacy Trust Account - State 350,000
2,113,000 Problem Gambling Account - State 1,420,151 2,113,000 1,627,000
685,383,000 Hospital Safety Net Assessment Acct - State 696,732,434 685,383,000 699,307,000
80,860,000 Health Benefit Exchange Account - State 65,095,176 80,860,000 76,214,000
Medicaid Fraud Penalty Account - State
Indian Health Improvement Rein Acct - State (0)
14,317,000 Ambulance Transport Fund - State 14,317,000 13,872,000
8,034,000 Telebehavorial Health Access Accoun - State 8,034,000 7,788,000
55,000,000 State Health Care Affordability Acc - State 55,000,000 110,000,000
1,795,000 Stw988BehavHealth&SuicidePrevLine - State 1,795,000 96,684,000
110,290,000 Dedicated Cannabis Account - State 102,807,273 110,290,000 113,876,000
39,296,000 St Health Care Authority Admin Acct - State 32,026,767 39,296,000 43,867,000
5,084,000 5,084,000 SW Info Tech Sys Dev Rev Acct - State
Pension Funding Stabilization Acct - State 5,695,058
28,317,000 School Employees' Insur Admin Acct - State 31,920,074 28,317,000 33,630,000
540,000 Medical Aid Account - State 532,894 540,000 540,000
4,000 4,000 - State
Distributor Opioid Abatement Settle - State 46,951,000
25,324,463,359 (551,278,641) Total Appropriated Funds 29,943,618,219 25,875,742,000 26,761,911,000

Non-Appropriated Funds

Operating Budget: Program Summary

Program Title Actual Estimated Proposed
Actual Estimated Estimated Proposed Proposed
Annual Total 11,841,964,302 13,096,857,665 4,545,633,460 13,656,743,000 13,105,168,000

Operating Budget: Change from Preceding Biennium

Actual Estimated Proposed
Amount Percent Amount Percent Amount Percent
3,604,496,619 19.0% (4,941,120,303) (21.9%) 9,119,419,875 51.7%

Employment Summary

  Actual Estimated Proposed
  2020-21 Actual 2021-22 Estimated 2022-23 Estimated 2023-24 Proposed 2024-25 Proposed
FTE Staff Years 1,340.4 1,432.0 1,488.5 1,527.6 1,568.4