All Roll Calls
Yes: 116 • No: 77
WashingtonSB 50832025-2026 Regular SessionSenateWALLET
Ensuring access to primary care, behavioral health, and affordable hospital services.
Sponsored By: June Robinson (Democratic)
Became Law
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 2 benefits, 0 costs, 4 mixed.
Hospital bill caps and no balance billing
Beginning Jan 1, 2027, your public employee plan caps what hospitals can be paid. In‑network hospital payments are the lowest of the bill, the plan’s contracted rate, or 200% of Medicare. Out‑of‑network hospital payments are the lower of the bill or 185% of Medicare. If a provider is paid under these rules, they cannot bill you extra beyond your copay or other plan cost‑sharing. These caps apply to hospital facility charges, not separate doctor professional fees.
Special caps for children’s hospitals
Beginning Jan 1, 2027, plans cap payments to children’s hospitals in King and Pierce counties. In‑network: the plan pays the lowest of the bill, the contracted rate, or a limit tied to each hospital’s Medicaid inpatient ratio (150% in King; 190% in Pierce). Out‑of‑network: the plan pays the lower of the bill or that ratio times 135% (King) or 175% (Pierce). These rules apply to hospitals mainly treating children.
Higher pay for primary and mental health
Beginning Jan 1, 2027, in‑network primary care services must be paid at least 150% of Medicare. In‑network non‑facility behavioral health services must also be paid at least 150% of Medicare. These floors aim to improve access to primary and mental health care. They can also change plan costs and future premiums.
Premiums must reflect new payment rules
Beginning Jan 1, 2027, premium setters for public employee plans must account for these hospital, primary care, and behavioral health payment changes. Your premium can go up or down based on how these reimbursements change.
Rural hospital pay floor and exceptions
Beginning Jan 1, 2027, Critical Access Hospitals must be paid at least 101% of allowable Medicare costs. The general caps do not apply to certain rural sole community hospitals or CAHs (unless part of a large health system), some island hospitals in Skagit County, and some tribal hospitals with high Medicare and Medicaid inpatient use. This supports rural access but can mean higher payments at exempt hospitals.
Medicare-based pricing rules and oversight
Beginning Jan 1, 2027, contractors may use alternative payment models if they reward quality and follow the law’s payment rules. Claims must include current‑year Medicare modifiers so the correct Medicare‑equivalent adjustments apply. The state defines Medicare‑equivalent amounts when Medicare has limited or no rates. Contractors must share cost and quality data when asked. The Health Care Authority can write and enforce rules, including fines.
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Sponsors & Cosponsors
Sponsor
June Robinson
Democratic • Senate
Cosponsors
Javier Valdez
Democratic • Senate
Jesse Salomon
Democratic • Senate
Marko Liias
Democratic • Senate
Paul Harris
Republican • Senate
T'wina Nobles
Democratic • Senate
Roll Call Votes
Senate vote • 4/24/2025
Final Passage as Amended by the House
Yes: 29 • No: 19
House vote • 4/22/2025
Final Passage as Amended by the House
Yes: 57 • No: 39 • Other: 2
Senate vote • 3/11/2025
3rd Reading & Final Passage
Yes: 30 • No: 19
Actions Timeline
Effective date 7/27/2025.
5/20/2025SenateChapter 373, 2025 Laws.
5/20/2025SenateGovernor signed.
5/20/2025legislatureDelivered to Governor.
4/27/2025legislatureSpeaker signed.
4/26/2025legislaturePresident signed.
4/25/2025legislaturePassed final passage; yeas, 29; nays, 19; absent, 0; excused, 0.
4/24/2025SenateSenate concurred in House amendments.
4/24/2025HouseThird reading, passed; yeas, 57; nays, 39; absent, 0; excused, 2.
4/22/2025SenateRules suspended. Placed on Third Reading.
4/22/2025SenateFloor amendment(s) adopted.
4/22/2025SenateRules Committee relieved of further consideration. Placed on second reading.
4/22/2025SenateReferred to Rules 2 Review.
3/27/2025SenateMinority; without recommendation.
3/24/2025SenateMinority; do not pass.
3/24/2025SenateAPP - Majority; do pass.
3/24/2025SenateAPP - Executive action taken by committee.
3/24/2025SenateFirst reading, referred to Appropriations.
3/13/2025SenateThird reading, passed; yeas, 30; nays, 19; absent, 0; excused, 0.
3/11/2025SenateRules suspended. Placed on Third Reading.
3/11/2025SenateFloor amendment(s) adopted.
3/11/2025Senate2nd substitute bill substituted.
3/11/2025SenatePlaced on second reading by Rules Committee.
3/7/2025SenatePassed to Rules Committee for second reading.
2/28/2025SenateMinority; without recommendation.
2/27/2025Senate
Bill Text
Session Law
5/23/2025
Bill as Passed Legislature
4/27/2025
Engrossed Second Substitute
3/11/2025
Second Substitute
2/28/2025
Substitute Bill
2/12/2025
Original Bill
1/14/2025
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