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WashingtonHB 13922025-2026 Regular SessionHouse

Creating the medicaid access program.

Sponsored By: Nicole Macri (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

7 provisions identified: 4 benefits, 3 costs, 0 mixed.

Higher payments for Washington Medicaid providers

By the second program plan year, Washington raises payments for listed professional services paid below Medicare rates on December 31, 2024. The increase uses a uniform percentage of those Medicare rates, limited by money collected in the prior plan year. Starting in the third plan year, yearly adjustments use the latest Medicare Economic Index, which tracks medical practice costs. Implementation requires federal approval, needed managed care contract changes, and state certification that approved funding fully supports the rates. The state must study access and quality by January 1 of the third plan year and every two years afterward.

Medicaid access program faces approval deadline

The law took effect May 19, 2025, but program implementation requires final federal approval. Washington must submit the required Medicaid plan changes or waiver requests by September 1, 2025. The act expires without final federal approval by January 1, 2027; the state must notify affected parties and lawmakers. It is also null and void without the specified budget funding by June 30, 2025. These provisions do not establish whether approval or funding has occurred.

Health insurers pay new Medicaid assessments

Assessments begin January 1 of the plan year after required federal approval, once contract and state funding requirements are satisfied. Initial monthly rates are $16 per covered person for Medicaid managed care organizations and $0.50 for fully insured health carriers. Rates receive Medicare Economic Index adjustments in the first plan year and annually afterward. Total managed care collections must be 36 times carrier collections, with a cap of 2.3 million member months per organization or carrier. Carrier assessments apply to group coverage first, then individual coverage; Medicare Advantage and standalone Part D plans are excluded. Payments are due within 45 days of the payment schedule, with interest afterward. The law does not require insurers to pass these costs to households.

Legal protections for Medicaid program administrators

The law protects covered state actors, insurers, managed care organizations, and employees from civil or criminal liability for good-faith program work. Protection covers actions and inaction while carrying out assigned program powers and duties. Lawsuits to enforce the program's legal or contract obligations remain allowed.

More Medicaid funding for school health

The program permits up to $2 million for school-based Medicaid expansion work. It also permits up to $2 million for related administrative and service costs. Funding supports school health services, school health centers, and on-site behavioral health services. These spending limits do not guarantee any family a specific service or payment.

Dedicated funding for Washington Medicaid payments

A dedicated state account holds Medicaid access assessments, interest, and penalties; spending requires legislative approval. It pays program costs, providers, managed care organizations, the state's share of increased managed care payments, and assessment refunds. In the first fiscal year after federal approval and assessment authorization, up to $35 million can replace general fund Medicaid spending. That substitution changes the funding source, rather than adding $35 million in benefits. The account receives monthly treasury investment earnings based on its average daily balance, with the rule continuing July 1, 2028. The law also clarifies state authority over federal cash-management transfers and permits treasury banking costs without a separate appropriation.

Medicaid providers face excess payment refunds

After all appeals, a final court ruling that program assessments or payment increases violate federal law triggers federal repayment. Washington must repay the federal government in the same proportion as the original funding. The state can require providers to return excess program payments. For providers unable to repay, the state must arrange installments, deduct future Medicaid payments, or use both. Medicaid households have no general repayment duty under this rule.

Sponsors & Cosponsors

Sponsor

  • Nicole Macri

    Democratic • House

Cosponsors

  • Adam Bernbaum

    Democratic • House

  • Alex Ramel

    Democratic • House

  • Alicia Rule

    Democratic • House

  • Beth Doglio

    Democratic • House

  • Chipalo Street

    Democratic • House

  • Chris Stearns

    Democratic • House

  • Cindy Ryu

    Democratic • House

  • Emily Alvarado

    Democratic • House

  • Gerry Pollet

    Democratic • House

  • Jake Fey

    Democratic • House

  • Jamila Taylor

    Democratic • House

  • Julia Reed

    Democratic • House

  • Lauren Davis

    Democratic • House

  • Lisa Callan

    Democratic • House

  • Liz Berry

    Democratic • House

  • Mari Leavitt

    Democratic • House

  • Mary Fosse

    Democratic • House

  • Osman Salahuddin

    Democratic • House

  • Sharon Tomiko Santos

    Democratic • House

  • Shaun Scott

    Democratic • House

  • Steve Tharinger

    Democratic • House

  • Strom Peterson

    Democratic • House

  • Tarra Simmons

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 144 • No: 95

House vote • 4/19/2025

Final Passage as Amended by the Senate

Yes: 57 • No: 38 • Other: 3

Senate vote • 4/14/2025

3rd Reading & Final Passage as Amended by the Senate

Yes: 31 • No: 18

House vote • 3/20/2025

3rd Reading & Final Passage

Yes: 56 • No: 39 • Other: 3

Actions Timeline

  1. Effective date 5/19/2025*.

    5/19/2025House

  2. Chapter 359, 2025 Laws.

    5/19/2025House

  3. Governor signed.

    5/19/2025legislature

  4. Delivered to Governor.

    4/23/2025legislature

  5. President signed.

    4/23/2025legislature

  6. Speaker signed.

    4/22/2025legislature

  7. Passed final passage; yeas, 57; nays, 38; absent, 0; excused, 3.

    4/19/2025House

  8. House concurred in Senate amendments.

    4/19/2025House

  9. Third reading, passed; yeas, 31; nays, 18; absent, 0; excused, 0.

    4/14/2025House

  10. Rules suspended. Placed on Third Reading.

    4/14/2025House

  11. Committee amendment(s) adopted as amended.

    4/14/2025House

  12. Placed on second reading by Rules Committee.

    4/9/2025House

  13. Passed to Rules Committee for second reading.

    4/8/2025House

  14. Minority; without recommendation.

    4/7/2025House

  15. Minority; do not pass.

    4/7/2025House

  16. WM - Majority; do pass with amendment(s).

    4/7/2025House

  17. First reading, referred to Ways & Means.

    3/24/2025House

  18. Third reading, passed; yeas, 56; nays, 39; absent, 0; excused, 3.

    3/20/2025House

  19. Rules suspended. Placed on Third Reading.

    3/20/2025House

  20. 1st substitute bill substituted.

    3/20/2025House

  21. Rules Committee relieved of further consideration. Placed on second reading.

    3/4/2025House

  22. Referred to Rules 2 Review.

    2/28/2025House

  23. APP - Executive action taken by committee.

    2/27/2025House

  24. Minority; do not pass.

    2/27/2025House

  25. APP - Majority; 1st substitute bill be substituted, do pass.

    2/27/2025House

Bill Text

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