Washington's Physician Community Rallies Behind Medicaid Access Program Legislation

House Bill 1392 and Senate Bill 5372 would increase patient access to care by improving Washington state's Medicaid reimbursements for health professionals.

SEATTLE, WA, UNITED STATES, February 13, 2025 /EINPresswire.com/ -- With legislative hearings slated for this week and next, the Washington State Medical Association (WSMA) and a coalition of health care organizations are rallying support for legislation establishing the Medicaid Access Program, which would leverage federal funds for Washington’s Medicaid program. Such funding is desperately needed to improve access to care for our state’s most vulnerable patients.

“Understand that Medicaid in Washington state covers nearly a quarter of the state’s residents. The goal of the Medicaid Access Program is simple: To ensure those Washingtonians can access the care they need within their communities,” says WSMA President John Bramhall, MD, PhD. The WSMA represents nearly 13,000 physicians from all specialties and practice types throughout Washington, as well as physician assistants, resident physicians, and medical students.

Washington state’s Medicaid program is dismally out of touch with the cost of providing care to patients. Washington state is one of the worst states in the nation when it comes to reimbursing physicians for the services they provide, in some cases paying below 60% of what Medicare pays. HB 1392 and SB 5372 would reverse that trend and provide payment for services on par with what Medicare pays, ensuring that Medicaid patients have improved access to essential services such as primary care, cancer treatments, joint replacements, OB-GYN and well-child care for mothers and babies, X-rays, and more.

“For my independent radiology practice, Medicaid covers less than half the actual cost of delivering care,” says Douglas Seiler, MD, president of TRA Medical Imaging in Tacoma. “Because of this unsustainable reimbursement model, we have had to close offices or scale back operations in two of the communities we serve. Unfortunately, patients will have to wait longer for imaging services and often receive care at higher-cost facilities. We're just asking for rates to keep our practices healthy so that we can, in turn, keep our patients healthy.”

First introduced during the 2024 legislative session, the Medicaid Access Program legislation has benefited from collaborative workshopping led by the WSMA in the run-up to the 2025 legislative session, which included legislators, the state Health Care Authority (which operates the state’s Medicaid program, known as Apple Health), and other stakeholders.

“The Medicaid Access Program bills being considered these next few weeks are truly a collaborative effort,” said Dr. Bramhall. “Everyone at the table has agreed that low Medicaid rates are having a significant impact on access to crucial services, particularly in Washington’s rural and other vulnerable communities. These bills very much reflect everyone’s genuine desire to invest in our communities and the folks on the ground providing these essential services, and we owe a debt of gratitude for everyone’s willingness to work together toward a solution.”

Scheduled for respective hearings in the House Appropriations Committee this Thursday, Feb. 13, and the Senate Health Care Committee on Thursday, Feb. 20, HB 1392 and SB 5372 would implement the Medicaid Access Program in Washington state beginning in 2026. At the heart of the program is an assessment, similar to assessments in place for Washington’s hospitals, ambulances, and nursing homes, that would be applied to insurance carriers. The assessment would then be used to draw down federal matching funds to invest in Washington’s Medicaid program by raising Medicaid rates to Medicare levels.

As the WSMA and its partner societies have been saying in recent years, investments in the state’s Medicaid program cannot come too soon. Medical association survey data continues to show Medicaid enrollees are increasingly struggling to access specialty care in their communities, with physician practices increasingly unable to accommodate the number of Medicaid patients needing care. Illustrating the near-universal agreement on the scope of the problem and the solution needed, the Medicaid Access Program bills have the support of nearly all of the state’s medical associations, specialty societies, and county medical societies, along with a large number of clinics and medical groups, hospitals (including the state hospital association), and patient advocacy groups.

“Half of children in Washington state depend on Medicaid and live in families where every penny counts,” says Beth Ebel, MD, president of the Washington Chapter of the American Academy of Pediatrics. “These kids face delays and barriers when they need timely specialty treatment, while kids with commercial insurance do not. This inequity falls hardest on kids living in rural areas where there just aren’t options.”

“This is not an individual doctor-and-patient problem, it’s a systemic problem—and it’s one our Legislature can solve,” said Dr. Bramhall. “We know this approach works: Physicians frequently cite low reimbursements as limiting their ability to see more Medicaid patients. Funding raised from the Medicaid Access Program in HB 1392 and SB 5372 would improve access for critical care such as pediatric neonatal care, cancer diagnosis, joint replacements, X-rays, and more. For patients throughout Washington, these are not optional services—these are essential to living a good, healthy life.”

For more information on the Medicaid Access Program, visit takeaction.wsma.org.

Physician interviews and survey data available upon request.

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About the Washington State Medical Association
The Washington State Medical Association represents nearly 13,000 physicians, resident physicians, physician assistants, and medical students across all specialties and practice types in Washington state. The WSMA has advocated on behalf of the house of medicine for more than 125 years. Our vision is to make Washington state the best place to practice medicine and receive care.

Graham F Short
Washington State Medical Association
+ +1 206-329-6851
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