Medicaid Reimbursement

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.

Building off of WSMA’s success in recent legislative sessions in increasing Medicaid reimbursement for some primary care, pediatric, and behavioral health services, the WSMA is asking the Washington Legislature to pass the Medicaid Access Program, which is designed to increase Medicaid rates across the board for all physicians in all settings to at least the equivalents paid by Medicare.

As we look ahead to the 2025 legislative session, we know that to be successful we’ll need the full support of the physician and practice community. Use resources on this page to help support the Medicaid Access Program in your community.

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 by:

• Sending a message to legislators.
• Meeting with your legislator.
• Submitting an op-ed or letter to the editor to your local media outlet.
• Sharing your support with your staff, your colleagues, and your patients.
• Joining our grassroots advocacy list for more direct advocacy opportunities.

Fact Sheets and One-pagers

• Medicaid Access Program: Fact Sheet
• Access to Care for Medicaid Patients: Fact Sheet
• Medicaid Access Program: Partner Action Plan

Social Media Toolkit

• Social media toolkit for September-October 2024

Media Coverage

• Why primary care physicians are becoming harder to find in Washington – The Seattle Times, Aug. 7, 2024
• Doctors struggle to afford Medicaid patients. How can WA solve the problem? – The Washington Observer, July 1, 2024
• More on the Medicaid [Reimbursement] Problem | The Washington Observer – The Washington Observer, July 22, 2024
• Can’t get into your doctor’s office? You’re not alone – The Seattle Times op-ed, May 20, 2024

Supporting Data

• Health Affairs, Physician Acceptance of New Medicaid Patients: What Matters and What Doesn’t, April 2019
• Washington State Health Care Authority’s Apple Health client eligibility dashboard.
• “Medicaid Patients Have Greater Difficulty Scheduling Health Care Appointments Compared With Private Insurance Patients: A Meta-Analysis.” INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2019.
• Washington State Medical Association survey of Medicaid patients, fall 2023.
• KFF’s Medicaid and Racial Health Equity, June 2023.
• KFF’s Medicaid-to-Medicare Fee Index.
• KFF’s Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier.