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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 37,687,345,000
Net change from current biennium 5,754,317,000 Increase
Percent change from current biennium 18.0% Increase

Operating Budget: Summary

Appropriated Funds

2023-25 Appropriations Appropriated Funds Expenditures
Amount Estimated Balance   2021-23 Actual 2023-25 Estimated 2025-27 Proposed
(56,669,000) General Fund - 56,669,000 2,570,000
19,974,462,000 60,854,000 General Fund - Federal 18,505,421,335 19,913,608,000 23,665,626,000
Coronavirus St Fiscal Recovery Fund - Federal 189,493,024
1,291,177,000 General Fund - Private/Local 372,599,791 1,291,177,000 1,860,269,000
100,000 100,000 Problem Gambling Account - Private/Local
Industrial Insurance Premium Refund - Nonappropriated
Fire Service Training Account - Nonappropriated 2,063,000
Flexible Spending Admin Account - Nonappropriated 1,898,341 9,000
(62,000) Prescription Drug Consortium Acct - Nonappropriated 636 62,000 62,000
Salary Reduction Account - Nonappropriated 90,029,969
(491,045,000) Basic Health Plan Trust Account - Nonappropriated 491,060,000 491,045,000 473,977,000
(1,416,000) Indian Health Improvement Rein Acct - Nonappropriated 23,023,444 1,416,000 1,512,000
Uniform Dental Plan Benefits Admin - Nonappropriated 13,516,306 16,745,000
Uniform Medical Plan Benefits Acct - Nonappropriated 129,221,197 157,699,000
Info Tech Invest Rev Acct - Nonappropriated
SEBB Flex Spend Dep Care Admin Acct - Nonappropriated 806,855 1,259,000
SEBB Dental Benefits Admin Acct - Nonappropriated 10,379,200 14,223,000
(16,513,000) School Employees' Insurance Account - Nonappropriated 3,606,430,136 16,513,000 36,590,000
SEBB Medical Benefits Admin Acct - Nonappropriated 45,043,070 63,038,000
Public Employees/Retirees Insurance - Nonappropriated 5,392,072,241
SEBB Salary Reduction Account - Nonappropriated 48,259,743
8,123,778,000 1,000,000 General Fund - State 6,795,146,566 8,122,778,000 8,902,146,000
15,086,000 Emer Med Ser/Trauma Care Sys Trust - State 15,086,000 15,086,000 15,092,000
22,001,000 Criminal Justice Treatment Account - State 21,939,881 22,001,000 22,046,000
Disaster Response Account - State
350,000 Education Legacy Trust Account - State 350,000 350,000
3,738,000 Problem Gambling Account - State 2,090,448 3,738,000 3,255,000
1,517,493,000 Hospital Safety Net Assessment Acct - State 682,687,437 1,517,493,000 1,886,062,000
83,528,000 Health Benefit Exchange Account - State 77,327,220 83,528,000 85,030,000
Indian Health Improvement Rein Acct - State
14,316,000 Ambulance Transport Fund - State 14,309,978 14,316,000 12,388,000
8,318,000 Telebehavorial Health Access Accoun - State 6,838,576 8,318,000 8,490,000
125,000,000 State Health Care Affordability Acc - State 11,599,368 125,000,000 85,000,000
45,123,000 Stw988BehavHealth&SuicidePrevLine - State 711,947 45,123,000 59,161,000
99,637,000 Opioid Abatement Settlement Account - State 99,637,000 97,862,000
7,000,000 7,000,000 Family Medicine Workforce Dev Acct - State
Tribal Opioid Prev & Treatment Acc - State 16,381,000
104,316,000 Dedicated Cannabis Account - State 101,936,142 104,316,000 100,738,000
44,982,000 44,982,000 St Health Care Authority Admin Acct - State 37,824,737 50,047,000
2,629,000 2,629,000 SW Info Tech Sys Dev Rev Acct - State 266,583
Pension Funding Stabilization Acct - State
33,739,000 33,739,000 School Employees' Insur Admin Acct - State 27,383,380 36,968,000
314,000 Long-Term Servs & Sup Trust Account - State 314,000 10,142,000
540,000 Medical Aid Account - State 539,882 540,000 545,000
31,517,627,000 (415,401,000) Total Appropriated Funds 36,714,943,434 31,933,028,000 37,687,345,000

Non-Appropriated Funds

Operating Budget: Program Summary

Program Title Actual Estimated Proposed
Actual Estimated Estimated Proposed Proposed
Annual Total 14,481,293,679 14,696,776,019 7,106,124,883 19,072,441,000 18,578,314,000

Operating Budget: Change from Preceding Biennium

Actual Estimated Proposed
Amount Percent Amount Percent Amount Percent
5,006,785,140 22.2% (5,775,250,442) (20.9%) 15,847,854,098 72.7%

Employment Summary

  Actual Estimated Proposed
  2022-23 Actual 2023-24 Estimated 2024-25 Estimated 2025-26 Proposed 2026-27 Proposed
FTE Staff Years 1,546.0 1,679.7 1,753.7 1,663.6 1,774.6