WSMA Priorities for the 2026 Legislative Session

The 2026 legislative session began on Monday, Jan. 12, and over the next 60 days, lawmakers will be working to bridge an ongoing state budget deficit and consider more than 3,000 bills that are in play in Olympia this year.

Last week, WSMA’s government affairs department held a pre-session webinar where more than 100 physicians, residents, and medical students were provided a high-level overview of what’s on the table for the physician community this session. If you weren’t able to attend, a video of the event can be found here and below is a summary of WSMA’s 2026 legislative priorities.

• Budget
  • H.R. 1 response
    • The tax and spending bill approved by Congress and signed into law by President Donald Trump in July contains numerous policies cutting federal funding for health care and limiting patients’ eligibility for enrollment in Medicaid. The WSMA is working in coalition with patient groups, state agencies, and other stakeholders to develop policy solutions to ensure as many residents of the state have access to essential health care services as possible.
  • B&O tax mitigation
    • Following business and occupation tax rate increases in 2019 and 2025, for most physician organizations the B&O tax rate has increased by 40% in the last five years. Taken together, these tax increases cost health care organizations an estimated $100 million annually. The WSMA is asking the Legislature to revisit the B&O tax rate for physician groups and health care organizations, mitigating the impact of recent increases in the interest of preserving independent practice and patient access to care.
  • Medicaid rates
    • WSMA successfully advocated for the passage of House Bill 1392 during the 2025 session, establishing the Medicaid Access Program to increase Medicaid rates. Unfortunately, H.R. 1 includes a provision that blocks implementation of the law. While we continue to monitor for opportunities to pursue federal approval, we will be exploring alternative methods to increase Medicaid rates and promote access to care for patients. And we are also advocating for the passage of House Bill 2385 to extend the statutory deadlines of the Medicaid Access Program so that the state can pursue implementation of the law if the federal landscape changes.
• Policy
  • Vaccine and preventative service access
    • As federal institutions continue to move away from evidence-based recommendations on public health measures, our state’s coverage of and access to immunizations and other preventative services are at risk. The WSMA is working in coalition to support House Bill 2242 and Senate Bill 5967 to preserve access to preventative services, including vaccines, on a covered basis through health insurance plans and the state’s Childhood Vaccine Program.
  • Prior authorization
    • When physicians recommend a service or a drug for a patient, coverage is often conditioned on prior authorization from a patient’s insurance carrier. The WSMA is grateful for recent legislative action to modernize prior authorization. As technology advances, further reform is needed to ensure care can be delivered in an appropriate and expeditious manner. The WSMA is working in coalition to advance Senate Bill 5395 to prohibit artificial intelligence from being used to deny coverage for services, require insurance carrier prior authorization policies be accessible in a standardized manner, and clarify an existing prohibition on retroactive denials of coverage authorizations.
  • Insurance payment reforms
    • The administrative and financial burdens associated with insurance contracting and payment constitute a significant challenge in maintaining independent physician practices. The requirements from any given insurance carrier can be difficult to navigate; taken together across carriers, they form a complex and shifting labyrinth of hurdles for practices to navigate. We’re advocating for Senate Bill 5845 to require insurance carriers to provide prompt payment for care that is delivered; Senate Bill 6071 to limit the ability of carriers to claw back payment after care is delivered; and House Bill 2106 to require approval of significant contract revisions between insurance carriers and practices.
  • Medical title transparency
    • As care delivery has evolved to be more team-based, the credentials and titles used by health care practitioners play a crucial role in ensuring transparency and trust with patients. Similar to laws currently on the books in 38 states, House Bill 2261 would require disclosure of credentials in advertising and badging. This bill was developed by the WSMA in conjunction with physician specialty organizations.
  • Scope of practice
    • The WSMA annually engages on a host of scope of practice bills pursuant to our established policy that focuses on appropriate education and training to ensure patient safety. In the 2026 session, we’re expecting to work on scope proposals from pharmacists, naturopaths, psychologists, and nurses, in addition to returning proposals mandating reimbursement for advance practice providers at the same rate as physicians.

As session progresses, we’ll be sharing opportunities for WSMA members to engage on these issues and others. If you have questions about our priority issues or anything that’s being considered in Olympia this year, contact WSMA Senior Director of Government Affairs and Policy Sean Graham.