Medicaid Reimbursement

At the top of the list of WSMA's accomplishments during the 2025 state legislative session is the passage of House Bill 1392, the WSMA’s Medicaid Access Program legislation to increase reimbursements for all services provided by physicians, physician assistants, and other advance practice providers to at least Medicare levels and index to inflation, representing a multiyear advocacy effort on the part of the physician community.

Why HB 1392 is needed: Washington state’s Medicaid reimbursement rates are some of the worst in the nation, falling far short of the cost of providing care. For patients, the result is difficulty getting appointments, delays in care, and worsening health conditions. For doctors, the result is frustration and burnout, as most practices simply cannot afford to see the number of Medicaid patients in their communities who need care.

HB 1392 proposes the establishment of a covered lives assessment on insurance carriers to leverage around $400 million per year for Medicaid rate increases across primary and specialty care. The bill was sponsored by Rep. Nicole Macri (D-Capitol Hill) and approved by the House and Senate on largely party-line votes. The bill is pending final approval from Gov. Bob Ferguson.

In the coming months, the WSMA will be working with the governor’s office and the state Health Care Authority to seek approval from the Centers for Medicare and Medicaid Services for the program. Assuming the program is approved, the assessment on insurance carriers will commence on Jan. 1 of the year following CMS approval and rate increases will begin Jan. 1 of the year after that.

Pediatrician Beth Ebel, MD, on the Medicaid Access Program

Dr. Beth Ebel, president of the Washington Chapter of the American Academy of Pediatrics, was interviewed by KOMO-TV’s Preston Phillips for ARC Seattle’s evening program, airing on Feb. 18, 2025. Dr. Ebel discusses why the physician community has united to urge the Legislature to pass the Medicaid Access Program in House Bill 1392 and Senate Bill 5372, a funding plan that will bring approximately $400 million per year in federal funding to Washington state and help increase access to primary and specialty services for our state’s children and adults.

Resources to help amplify our advocacy for the Medicaid Access Program, below.

Medicaid Advocacy Campaign Website

Visit the WSMA's dedicated Medicaid campaign website at takeaction.wsma.org for information on how you and your organization can help support the Medicaid Access Program.