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Agency: 107 - Washington State Health Care Authority

Last Updated: 10/08/2025

H001 - HCA Administration

Administration encompasses the executive and general administrative oversight of the agency. Functions in this area include: executive leadership, financial management, employee services, facilities, legal support, and administrative support.

Account FY 2026 FY 2027 Biennium Total
FTE 63.4 67.7 67.7
08G - Flexible Spending Admin Account
Non-Appropriated 125,000 127,000 252,000
418 - St Health Care Authority Admin Acct
State 8,335,000 8,753,000 17,088,000
474 - SEBB Flex Spend Dep Care Admin Acct
Non-Appropriated 125,000 127,000 252,000
492 - School Employees' Insur Admin Acct
State 7,575,000 7,981,000 15,556,000
Account FY 2026 FY 2027 Biennium Total
FTE 370.5 404.3 404.3
001 - General Fund
State 23,156,000 20,079,000 43,235,000
Federal 71,985,000 78,002,000 149,987,000
Local 226,445,000 226,148,000 452,593,000
Medicaid Federal 514,615,000 509,084,000 1,023,699,000
03C - Emer Med Ser/Trauma Care Sys Trust
State 43,000 43,000 86,000
16W - Hospital Safety Net Assessment Acct
State 242,000 245,000 487,000
24L - Ambulance Transport Fund
State 68,000 68,000 136,000
24V - Telebehavorial Health Access Accoun
State 150,000 150,000 300,000
29D - Medicaid Access Program Account
State 8,053,000 8,053,000
567 - Long-Term Servs & Sup Trust Account
State 1,473,000 2,190,000 3,663,000
609 - Medical Aid Account
State 43,000 43,000 86,000
FY 2026 FY 2027 Biennium Total
FTES 433.9 472 453
GFS 23,156,000 20,079,000 43,235,000
Other 831,224,000 841,014,000 1,672,238,000
Totals 854,380,000 861,093,000 1,715,473,000

Expected Results

Provide leadership and administrative support for the agency’s activities to ensure the most effective use of public resources.

H002 - HCA Direct Operations

Direct Operations represents those activities where there is direct contact with clients, enrollees, and/or providers in the delivery of benefits or the development of policy that impacts benefits. Functions in this area include: eligibility determination, coordination of benefits, call center operations, claims processing, pre-authorization review, hearings and appeals, program integrity, provider and hospital rate development, healthcare benefits and utilization management, and quality and care management..

Account FY 2026 FY 2027 Biennium Total
FTE 4.1 4.3 4.3
08G - Flexible Spending Admin Account
Non-Appropriated 2,000 2,000 4,000
418 - St Health Care Authority Admin Acct
State 679,000 689,000 1,368,000
474 - SEBB Flex Spend Dep Care Admin Acct
Non-Appropriated 2,000 2,000 4,000
492 - School Employees' Insur Admin Acct
State 432,000 440,000 872,000
Account FY 2026 FY 2027 Biennium Total
FTE 714.5 782.7 782.7
001 - General Fund
State 56,046,000 55,985,000 112,031,000
Federal 11,304,000 12,422,000 23,726,000
Local 2,358,000 2,396,000 4,754,000
Medicaid Federal 80,811,000 81,070,000 161,881,000
08J - Prescription Drug Consortium Acct
Non-Appropriated 31,000 31,000 62,000
16W - Hospital Safety Net Assessment Acct
State 756,000 757,000 1,513,000
23L - Indian Health Improvement Rein Acct
Non-Appropriated 703,000 708,000 1,411,000
24V - Telebehavorial Health Access Accoun
State 3,654,000 3,654,000 7,308,000
29D - Medicaid Access Program Account
State 61,000 61,000
567 - Long-Term Servs & Sup Trust Account
State 1,991,000 3,262,000 5,253,000
609 - Medical Aid Account
State 228,000 226,000 454,000
FY 2026 FY 2027 Biennium Total
FTES 718.6 787 752.8
GFS 56,046,000 55,985,000 112,031,000
Other 102,951,000 105,720,000 208,671,000
Totals 158,997,000 161,705,000 320,702,000

Expected Results

Provide policy direction and oversight of state-paid benefits made on behalf of state employees and citizens. Ensure that public funds are used effectively and appropriately. Make prescription drugs more affordable to Washington residents and state health care programs.

H003 - HCA Information Technology

Information technology provides support for daily operations, ProviderOne System maintenance and enhancement efforts, the Health Information Technology (HIT) project, and other IT based projects.

Account FY 2026 FY 2027 Biennium Total
FTE 22.1 23.4 23.4
08G - Flexible Spending Admin Account
Non-Appropriated 14,000 14,000 28,000
418 - St Health Care Authority Admin Acct
State 3,663,000 3,331,000 6,994,000
474 - SEBB Flex Spend Dep Care Admin Acct
Non-Appropriated 14,000 14,000 28,000
492 - School Employees' Insur Admin Acct
State 3,237,000 3,029,000 6,266,000
Account FY 2026 FY 2027 Biennium Total
FTE 147.3 164.8 164.8
001 - General Fund
State 13,326,000 13,594,000 26,920,000
Federal 1,930,000 2,114,000 4,044,000
Local 496,000 500,000 996,000
Medicaid Federal 13,801,000 13,794,000 27,595,000
29D - Medicaid Access Program Account
State 111,000 111,000
567 - Long-Term Servs & Sup Trust Account
State 492,000 734,000 1,226,000
FY 2026 FY 2027 Biennium Total
FTES 169.4 188.2 178.8
GFS 13,326,000 13,594,000 26,920,000
Other 23,647,000 23,641,000 47,288,000
Totals 36,973,000 37,235,000 74,208,000

Expected Results

Provide efficient and secure IT systems for employees and providers. Ensure that payments made to providers are timely and accurate.

H004 - HCA Public Employee Benefits

This represents payments made to a Third Party Administrators to provide benefits to members (Uniform Medical and Dental) and costs associated with the Voluntary Employee Benefit Account (VEBA) and the Flexible Spending Account (FSA) programs.

Account FY 2026 FY 2027 Biennium Total
FTE 54.3 57.2 57.2
08G - Flexible Spending Admin Account
Non-Appropriated 853,000 912,000 1,765,000
418 - St Health Care Authority Admin Acct
State 8,910,000 10,169,000 19,079,000
438 - Uniform Dental Plan Benefits Admin
Non-Appropriated 8,369,000 8,376,000 16,745,000
439 - Uniform Medical Plan Benefits Acct
Non-Appropriated 77,888,000 79,811,000 157,699,000
FY 2026 FY 2027 Biennium Total
FTES 54.3 57.2 55.8
GFS
Other 96,020,000 99,268,000 195,288,000
Totals 96,020,000 99,268,000 195,288,000

Expected Results

Provide a high-quality benefits package while controlling costs.

H005 - HCA National Health Reform

This represents costs and workload driven by the implementation of the Affordable Care Act (ACA).

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 371,516,000 335,754,000 707,270,000
Federal 546,868,000 576,443,000 1,123,311,000
Local 425,467,000 434,269,000 859,736,000
Medicaid Federal 4,009,297,000 3,660,558,000 7,669,855,000
24L - Ambulance Transport Fund
State 1,252,000 1,252,000 2,504,000
25N - Stw988BehavHealth&SuicidePrevLine
State 1,301,000 309,000 1,610,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 371,516,000 335,754,000 707,270,000
Other 4,984,185,000 4,672,831,000 9,657,016,000
Totals 5,355,701,000 5,008,585,000 10,364,286,000

Expected Results

Ensure Washington residents have access to high quality health care.

H007 - HCA Take Charge and Family Planning Extension Clients

The federally funded waiver program provides family planning services. Services include annual exams, birth control, emergency contraception, and limited testing for sexually transmitted infections.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 97,000 97,000 194,000
Federal 69,000 75,000 144,000
Medicaid Federal 493,000 488,000 981,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 97,000 97,000 194,000
Other 562,000 563,000 1,125,000
Totals 659,000 660,000 1,319,000

Expected Results

Maximize the use of federal resources. Ensure access to high quality health care.

H008 - HCA Children's Health Program Clients

Healthcare coverage is provided for children who are not eligible for Medicaid because their families do not meet medical income eligibility criteria or are unable to qualify for other reasons.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 58,495,000 55,748,000 114,243,000
Federal 1,404,000 1,447,000 2,851,000
Local 16,000 14,000 30,000
Medicaid Federal 10,035,000 9,441,000 19,476,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 58,495,000 55,748,000 114,243,000
Other 11,455,000 10,902,000 22,357,000
Totals 69,950,000 66,650,000 136,600,000

Expected Results

Ensure access to high quality health care for children.

H009 - HCA State Program Clients

Limited healthcare coverage is provided via state funding for clients who are not covered by Medicaid. Programs include Kidney Disease and Alien Emergency Medical.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 22,210,000 25,043,000 47,253,000
Federal 4,617,000 4,999,000 9,616,000
Local 4,000 4,000 8,000
Medicaid Federal 33,009,000 32,627,000 65,636,000
03C - Emer Med Ser/Trauma Care Sys Trust
State 7,500,000 7,500,000 15,000,000
16W - Hospital Safety Net Assessment Acct
State 1,909,000 1,909,000 3,818,000
23L - Indian Health Improvement Rein Acct
Non-Appropriated 7,505,000 7,505,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 22,210,000 25,043,000 47,253,000
Other 54,544,000 47,039,000 101,583,000
Totals 76,754,000 72,082,000 148,836,000

Expected Results

Ensure access to high quality health care.

H010 - HCA Apple Health

Healthcare is provided to Medicaid clients via the Apple Health managed care program. This activity also includes wrap around services that are paid for on a fee for service basis for these clients.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 1,791,775,000 1,762,490,000 3,554,265,000
Federal 232,522,000 247,813,000 480,335,000
Medicaid Federal 1,662,290,000 1,617,373,000 3,279,663,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 1,791,775,000 1,762,490,000 3,554,265,000
Other 1,894,812,000 1,865,186,000 3,759,998,000
Totals 3,686,587,000 3,627,676,000 7,314,263,000

Expected Results

Ensure access to high quality health care. Control cost increases through the use of managed care plans

H011 - HCA All Other Clients - Fee for Service - Mandatory Services

Federally mandated healthcare services are provided for Medicaid clients who are not in the state’s Apple Health managed care program. Clients include families and children eligible to receive Temporary Assistance to Needy Families (TANF); families and individuals terminated from TANF because they have increased earnings or hours of employment or Social Security Disability Insurance income; individuals who are ineligible for TANF because of requirements that do not apply to Medicaid; eligible pregnant women and their newborns; individuals receiving Social Security Income or those eligible to receive mandatory state supplements; and children in foster care or adoption support. Mandatory services for eligible clients include inpatient and outpatient hospital care, rural health clinic services, nursing home services for clients 21 years or older (other than those in mental hospitals or institutions for the developmentally disabled), Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) health care program for children, and physician care.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 955,061,000 964,377,000 1,919,438,000
Federal 188,070,000 214,558,000 402,628,000
Local 239,011,000 239,141,000 478,152,000
Medicaid Federal 1,344,507,000 1,400,331,000 2,744,838,000
16W - Hospital Safety Net Assessment Acct
State 226,000,000 226,000,000 452,000,000
172 - Basic Health Plan Trust Account
Non-Appropriated 227,205,000 232,235,000 459,440,000
24L - Ambulance Transport Fund
State 4,864,000 4,864,000 9,728,000
29D - Medicaid Access Program Account
State 26,775,000 26,775,000
315 - Dedicated Cannabis Account
State 19,780,000 20,850,000 40,630,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 955,061,000 964,377,000 1,919,438,000
Other 2,249,437,000 2,364,754,000 4,614,191,000
Totals 3,204,498,000 3,329,131,000 6,533,629,000

Expected Results

Ensure access to high quality health care.

H012 - HCA All Other Clients - Fee for Service - Optional Services

Optional healthcare services are provided for Medicaid clients who are not in the state’s Apple Health managed care program. Federal regulations allow states to cover optional services such as laboratory and X-ray services, hearing, dental, and vision care under Medicaid, as long as those services are listed in the state plan. Medicaid services are provided to those children who do not qualify under the federal mandatory guidelines, but live in families with incomes that fall within the State's criteria as a percentage of the federal poverty level. This activity also includes family planning clinics and pass- through dollars to school health services, school districts, Indian Nations, etc.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
Federal 228,792,000 210,079,000 438,871,000
Medicaid Federal 1,635,625,000 1,371,099,000 3,006,724,000
16W - Hospital Safety Net Assessment Acct
State 676,611,000 676,607,000 1,353,218,000
FY 2026 FY 2027 Biennium Total
FTES
GFS
Other 2,541,028,000 2,257,785,000 4,798,813,000
Totals 2,541,028,000 2,257,785,000 4,798,813,000

Expected Results

Ensure access to high quality health care.

H015 - Payments to Other Entities Related to Medicaid Administrative Costs and Other Costs Paid by HCA

HCA enters into agreements with other entities to provide the means for them to receive federal Medicaid funding to support their administrative costs. HCA partnerships include: school districts, Indian Nations, local health jurisdictions, and the Health Benefit Exchange.

Account FY 2026 FY 2027 Biennium Total
FTE
08G - Flexible Spending Admin Account
Non-Appropriated 7,000 7,000 14,000
418 - St Health Care Authority Admin Acct
State 1,086,000 1,003,000 2,089,000
474 - SEBB Flex Spend Dep Care Admin Acct
Non-Appropriated 7,000 6,000 13,000
492 - School Employees' Insur Admin Acct
State 567,000 496,000 1,063,000
Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 8,766,000 8,609,000 17,375,000
Medicaid Federal 42,335,000 42,478,000 84,813,000
American Rescue Plan Act (ARPA) 2,550,000 2,550,000
08A - Education Legacy Trust Account
State 150,000 200,000 350,000
17T - Health Benefit Exchange Account
State 42,581,000 43,449,000 86,030,000
25M - State Health Care Affordability Acc
State 55,000,000 30,000,000 85,000,000
Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 5,806,000 5,291,000 11,097,000
Federal 3,793,000 3,904,000 7,697,000
Local 1,765,000 1,589,000 3,354,000
Medicaid Federal 27,109,000 25,491,000 52,600,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 14,572,000 13,900,000 28,472,000
Other 176,950,000 148,623,000 325,573,000
Totals 191,522,000 162,523,000 354,045,000

Expected Results

Ensure access to high quality health care.

H016 - HCA School Employees Benefits

This represents the costs to design and obtain health care and other benefits for eligible school employees statewide.

Account FY 2026 FY 2027 Biennium Total
FTE 27.4 28.7 28.7
474 - SEBB Flex Spend Dep Care Admin Acct
Non-Appropriated 477,000 476,000 953,000
475 - SEBB Dental Benefits Admin Acct
Non-Appropriated 6,506,000 7,717,000 14,223,000
492 - School Employees' Insur Admin Acct
State 5,844,000 4,899,000 10,743,000
494 - SEBB Medical Benefits Admin Acct
Non-Appropriated 30,698,000 32,340,000 63,038,000
FY 2026 FY 2027 Biennium Total
FTES 27.4 28.7 28.1
GFS
Other 43,525,000 45,432,000 88,957,000
Totals 43,525,000 45,432,000 88,957,000

Expected Results

Provide a high-quality benefits package while controlling costs

C018 - Community Mental Health Services

Community Mental Health Services - financial support and program direction for community mental health programs delivered by Behavioral Health Organizations and Integrated Managed Care providers for Medicaid eligible and non-Medicaid eligible clients and services. Programs include mental health services for outpatient, inpatient, acute care, emergency, day treatment, consultation and education, employment services, and Medicaid Transportation. Community support services include screening of voluntary referrals to state hospitals, hospital discharge planning, crisis response, case management for chronic clients in the community, and residential programs that supervise, support, treat, and rehabilitate adults and children.

Account FY 2026 FY 2027 Biennium Total
FTE 10 10.4 10.4
001 - General Fund
State 1,023,859,000 1,028,239,000 2,052,098,000
Federal 87,778,000 87,246,000 175,024,000
Medicaid Federal 1,515,085,000 1,513,431,000 3,028,516,000
25N - Stw988BehavHealth&SuicidePrevLine
State 35,547,000 35,546,000 71,093,000
315 - Dedicated Cannabis Account
State 4,969,000 4,972,000 9,941,000
FY 2026 FY 2027 Biennium Total
FTES 10 10.4 10.2
GFS 1,023,859,000 1,028,239,000 2,052,098,000
Other 1,643,379,000 1,641,195,000 3,284,574,000
Totals 2,667,238,000 2,669,434,000 5,336,672,000

Expected Results

Provide and ensure quality and cost-effective mental health services that support the health and well-being of individuals, families and communities in Washington State

C900 - Program Support for Mental Health

Program Support provides administrative and technical support for all programs within Mental Health including policy development, fiscal planning, information services, federal demonstration grants as well as legislative and regional coordination.

Account FY 2026 FY 2027 Biennium Total
FTE 176.1 173.4 173.4
001 - General Fund
State 29,091,000 28,743,000 57,834,000
Federal 1,040,000 1,004,000 2,044,000
Local 19,458,000 19,469,000 38,927,000
Medicaid Federal 17,944,000 17,415,000 35,359,000
25N - Stw988BehavHealth&SuicidePrevLine
State 792,000 2,149,000 2,941,000
FY 2026 FY 2027 Biennium Total
FTES 176.1 173.4 174.8
GFS 29,091,000 28,743,000 57,834,000
Other 39,234,000 40,037,000 79,271,000
Totals 68,325,000 68,780,000 137,105,000

Expected Results

Account for its use of public dollars

G008 - Prevention Substance Use Disorder Services

Prevention Services are contracted by the Division of Behavioral Health and Recovery (DBHR) through Counties, the Office of the Superintendent of Public Instruction, or with community based providers. Prevention Services are designed to prevent or reduce the misuse and abuse of alcohol, marijuana, tobacco, and other drugs. Services include prevention education, best-practices, training, public education and awareness, technical support, and other substance use resources for providers and clients.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 2,363,000 2,363,000 4,726,000
Federal 51,000 51,000 102,000
Medicaid Federal 882,000 882,000 1,764,000
27W - Opioid Abatement Settlement Account
State 2,510,000 2,510,000 5,020,000
315 - Dedicated Cannabis Account
State 3,513,000 3,513,000 7,026,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 2,363,000 2,363,000 4,726,000
Other 6,956,000 6,956,000 13,912,000
Totals 9,319,000 9,319,000 18,638,000

Expected Results

Prevent or reduce the misuse and abuse of alcohol, marijuana, tobacco, and other drugs.

G015 - Community Substance Use Disorder Services

Financial support and program direction for community substance use disorder programs delivered by Behavioral Health Organizations and Integrated Managed Care providers for Medicaid eligible and non-Medicaid eligible clients and services. Programs include Community Engagement and Referral, Triage Services, Outpatient Treatment, Housing, Residential, Recovery Support and Secure Detox.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 90,815,000 90,814,000 181,629,000
Federal 83,000 83,000 166,000
Medicaid Federal 1,435,000 1,435,000 2,870,000
05C - Criminal Justice Treatment Account
State 10,738,000 10,738,000 21,476,000
27W - Opioid Abatement Settlement Account
State 5,299,000 5,299,000 10,598,000
315 - Dedicated Cannabis Account
State 14,339,000 14,339,000 28,678,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 90,815,000 90,814,000 181,629,000
Other 31,894,000 31,894,000 63,788,000
Totals 122,709,000 122,708,000 245,417,000

Expected Results

Implement a continuum of intervention and treatment services to meet local, regional, tribal, and statewide needs which specifically address the needs of adults, youth, women, children, and families.

G022 - Program Support for Substance Use Disorder

Program Support provides the administrative support for substance use disorder services. Activities include statewide program/policy development, strategic/fiscal planning, information system management, personnel, budget oversight, discretionary grants as well as legislative and regional coordination

Account FY 2026 FY 2027 Biennium Total
FTE 66.1 64.7 64.7
001 - General Fund
State 18,522,000 15,706,000 34,228,000
Federal 1,348,000 1,358,000 2,706,000
Local 144,000 129,000 273,000
Medicaid Federal 23,266,000 23,557,000 46,823,000
05C - Criminal Justice Treatment Account
State 1,283,000 1,283,000 2,566,000
08K - Problem Gambling Account
State 1,621,000 1,628,000 3,249,000
27W - Opioid Abatement Settlement Account
State 24,622,000 23,157,000 47,779,000
315 - Dedicated Cannabis Account
State 4,999,000 4,998,000 9,997,000
FY 2026 FY 2027 Biennium Total
FTES 66.1 64.7 65.4
GFS 18,522,000 15,706,000 34,228,000
Other 57,283,000 56,110,000 113,393,000
Totals 75,805,000 71,816,000 147,621,000

Expected Results

Provide and ensure quality services that support individuals and families in their efforts to raise children who are free of alcohol, marijuana, tobacco, and other drugs.

G085 - Residential Substance Use Disorder Treatment Services

Residential treatment includes intensive inpatient, long term, recovery house, and treatment services for American Indian/Alaskan Native clients and residential services delivered by BHO and IMC providers.

Account FY 2026 FY 2027 Biennium Total
FTE
001 - General Fund
State 3,400,000 3,400,000 6,800,000
05C - Criminal Justice Treatment Account
State 1,747,000 1,752,000 3,499,000
FY 2026 FY 2027 Biennium Total
FTES
GFS 3,400,000 3,400,000 6,800,000
Other 1,747,000 1,752,000 3,499,000
Totals 5,147,000 5,152,000 10,299,000

Expected Results

Implement a continuum of intervention and treatment services to meet local, regional, tribal, and statewide needs which specifically address the needs of adults, youth, women, chaildren, and families.

G098 - Support Services for Clients Receiving Substance Use Disorder Treatment

Support services include Parent Child Assistance for pregnant and parenting women, Fetal Alcohol Spectrum Disorders Diagnosis and Prevention, Parent Trust parenting education and family support services, Tribal and Non-Native Encounters and Treatment and Native American Government to Government contracts

Account FY 2026 FY 2027 Biennium Total
FTE 2.8 2.9 2.9
001 - General Fund
State 17,192,000 16,019,000 33,211,000
Federal 706,000 684,000 1,390,000
Medicaid Federal 13,762,000 10,294,000 24,056,000
27W - Opioid Abatement Settlement Account
State 7,028,000 7,038,000 14,066,000
29A - Tribal Opioid Prev & Treatment Acc
State 9,064,000 7,750,000 16,814,000
315 - Dedicated Cannabis Account
State 695,000 695,000 1,390,000
FY 2026 FY 2027 Biennium Total
FTES 2.8 2.9 2.9
GFS 17,192,000 16,019,000 33,211,000
Other 31,255,000 26,461,000 57,716,000
Totals 48,447,000 42,480,000 90,927,000

Expected Results

Provide clients the supports they need to prevent or reduce the misuse and abuse of alcohol, marijuana, tobacco, and other drugs.