The expertise, experience, and perspective of physicians and physician
assistants practicing in Washington is crucial to helping to inform our
advocacy on your behalf. And, it's often crucial in helping to inform
legislators' decision-making on policy being debated at the state and
On this page, we'll highlight some of WSMA's top advocacy priorities where
lawmakers need to hear from physicians and PAs directly.
The WSMA is also urging all of medicine to join us in advocating for the
state to increase Medicaid payments for all physicians. In the coming
weeks preceding the 2023 state legislative session that begins in January,
we need our members to reach out to your local legislators to urge their
Learn more about how to schedule a meeting with your legislator. Feel free to use the information below to help inform your ask.
Improve access to care for Washingtonians enrolled in Medicaid by
supporting an increase in Medicaid reimbursement rates for professional
services to the equivalent paid by Medicare, adjusting to inflation moving
forward. The estimated fiscal impact for the 2023-25 biennium is $200.4
million to the state's general fund, leveraging a more than 2:1 federal
match for an overall investment of $634.8 million.
that raising Medicaid reimbursement rates is the most effective method of
increasing physician and health care provider participation in Medicaid
networks. Prioritizing a broad-based Medicaid reimbursement rate increase
will improve access to care for Washingtonians by expanding physician
participation in Medicaid networks at a time when it is desperately needed
and long overdue.
Without access to quality health care services, preventable emergency room
visits increase as Washingtonians are forced to seek out episodic care,
and health outcomes worsen. These patterns exacerbate health disparities,
which have already been magnified by the pandemic.
The ACA Medicaid expansion and state-level program changes have led to
dramatically increased Medicaid eligibility, but it has been at least
a dozen years since there has been a broad-based Medicaid reimbursement
rate increase. The rate increases funded by the Legislature in 2021 for primary care,
behavioral health, and pediatric services were widely recognized as a
first step in addressing a long-overdue shortfall in Medicaid rates
because all specialties are impacted by low Medicaid reimbursement rates.
Patients with cancer diagnoses, joint replacement needs, and other
specialty services also deserve timely access to high-quality care.
Our state receives the
lowest federal contribution for Medicaid rates
only two states reimburse specialty health care services at lower
rates. When the state allocates funds toward Medicaid reimbursement, the
federal government contributes significant matching funds, stretching the
impact of state-level investments. While the WSMA is thankful for the
targeted investments previously allocated by the Legislature, Medicaid
rates need to be increased across the board for all specialty services to
truly improve access to care.
Physician practices, medical groups, and hospitals, like the rest of the
economy, are struggling with high inflation. They are also under enormous
pressure to catch up patients on care that was delayed or unchecked and
worsened during the pandemic with a workforce that has been depleted. But
while other sectors of the economy may increase prices to address the
economic downturn and inflation in order to meet demand, physicians
providing care for patients on Medicaid are at the mercy of the
Legislature and the state's budget.
Physicians want to be able to care for all patients, including
those on Medicaid. But financial pressures yield limitations on their
ability to do so, and financial viability is strained when they do. If
Medicaid reimbursement doesn't cover the cost of delivering care,
physicians have to limit the number of Medicaid patients they serve or
risk jeopardizing their ability to keep their practice doors open.
Medicaid enrollment in
our state stands at over 2.2 million, representing nearly 30 percent of our state's population and an
increase of around 400,000 since the beginning of the COVID pandemic.
Making matters worse, many people delayed seeking necessary medical care
throughout the pandemic, resulting in patients presenting in clinics and
health care facilities with more acute conditions. It's more important
than ever that all residents of our state have access to specialty medical
Medicaid disproportionately serves families of color, low-income
communities, and children - meaning that these patients
disproportionately face difficulty accessing timely, cost-effective
care. Medicaid is one of the primary avenues of health coverage for residents
of our state and it's imperative that the state help ensure access to care
for all of our state's residents by adjusting reimbursement rates to more
accurately reflect the cost of delivering care.