5 Critical Battles: What The Washington State Hospital Association Is Fighting For In 2025
The Washington State Hospital Association (WSHA) is currently at the forefront of a high-stakes legislative battle, grappling with a challenging economic forecast and a persistent healthcare workforce crisis as of late 2024 and heading into the 2025 legislative session. The organization, which represents nearly all hospitals and health systems across the state, is focused on securing financial stability for its members while simultaneously driving critical improvements in patient access, particularly for behavioral health services and rural communities.
The WSHA’s strategic agenda is a direct response to the severe financial pressures and staffing shortages that have plagued both large and small Washington hospitals. Their efforts are centered on five core priorities designed to protect essential services, invest in the future healthcare workforce, and ensure that every community, from Seattle to the most remote rural areas, maintains access to high-quality, equitable health care. The success or failure of these initiatives will profoundly shape the landscape of Washington state healthcare for the 2025-2027 biennium.
The WSHA's 2025-2027 Legislative Battleground: 5 Core Priorities
Facing a potential state budget shortfall, the WSHA has made its legislative priorities clear, focusing on measures that bolster the healthcare infrastructure and prevent a cascade of service reductions. These priorities are not merely requests, but essential steps to maintain the viability of the state’s healthcare system.
1. Protection Against Cuts and New Taxes Targeting Hospitals
The WSHA’s top-line priority for the 2025-2027 budget cycle is a firm stance against any cuts to existing hospital funding or the imposition of new taxes that specifically target hospitals. Hospitals in Washington State are already operating on extremely thin margins, with many rural facilities facing a precarious economic future. The association argues that any further financial strain would force facilities to reduce services, close essential units, or even face closure, directly impacting patient access and community health. This defensive strategy is seen as the cornerstone of maintaining financial stability across the state’s diverse hospital network.
2. Securing the Medicaid Professional Provider Rate Increase
A major focus of the WSHA’s advocacy is the push for a substantial Medicaid Professional Provider Rate Increase. Medicaid, known as Apple Health in Washington, pays significantly less than the actual cost of delivering care, creating a substantial financial gap for hospitals. This gap is exacerbated in rural and critical access hospitals, which serve a disproportionately high number of Medicaid patients. Increasing the reimbursement rate is a critical mechanism to ensure that hospitals can cover the costs of care for the state’s most vulnerable populations without having to subsidize these services through other means, which can strain overall hospital finances.
3. Funding for Rural Labor and Delivery Services
The loss of labor and delivery services in rural Washington communities is a growing public health concern, forcing expectant mothers to travel long distances for care. The WSHA is actively advocating for dedicated Rural Labor and Delivery Funding to stabilize and expand these essential services. This funding is crucial for reversing the trend of maternity unit closures, ensuring that rural families have safe, local access to obstetrics and perinatal care. This effort is a key component of the WSHA’s commitment to health equity.
The Critical Push for Washington's Healthcare Workforce
The healthcare workforce shortage, particularly in nursing, remains one of the most pressing issues facing Washington’s hospitals. The WSHA has championed programs and legislative support to build a robust pipeline of healthcare professionals, especially in underserved areas. This focus on workforce development is essential for the long-term sustainability of the state's healthcare system.
4. Expanding the Rural Nurse Education Program (RNEP)
The WSHA is a major supporter of the state’s Rural Nurse Education Program (RNEP), which was established through legislation (SB 5335). However, their current priority involves securing continued and expanded funding for this vital initiative. The RNEP is not just a general education program; it includes a dedicated Rural Nurse Leadership Program, which is designed to train and retain nurse managers, charge nurses, and clinical nurse educators in rural settings. By investing in leadership development for rural nurses, the WSHA aims to create a stable, high-quality nursing infrastructure in areas that struggle most with recruitment and turnover. The 2026 cohort registration is a sign of the program's ongoing success and importance.
5. Streamlining the New Law Implementation Guide
Following the 2024 legislative session, a number of new laws were passed that significantly impact hospital operations. The WSHA has taken a proactive role in developing a comprehensive New Law Implementation Guide. This guide is a critical resource for hospital administrators and legal teams, helping them navigate complex regulatory changes in areas ranging from staffing mandates to new public health reporting requirements. By providing clear, centralized guidance, the WSHA minimizes the administrative burden on hospitals, allowing them to focus resources on patient care rather than compliance confusion.
Addressing the Behavioral Health Crisis
The crisis in behavioral health—encompassing mental health and substance use disorder treatment—is a major focus for the Washington State Hospital Association. Hospitals are often the first and last resort for patients in crisis, and the WSHA is advocating for systemic solutions to alleviate the pressure on emergency departments and improve long-term care access.
The WSHA’s strategy involves both capacity expansion and program development. In the 2024 supplemental budget, the association successfully advocated for funding to support the operation of 75 long-term behavioral health beds through the University of Washington (UW), a crucial step in freeing up acute care beds. Furthermore, they are pushing for the expansion of partial hospitalization and intensive outpatient mental health programs. These programs provide a necessary step-down from inpatient care, offering intensive treatment without requiring a 24/7 hospital stay.
The association is also a key partner in the Children & Youth Behavioral Health Work Group, underscoring its commitment to early intervention and comprehensive care for younger populations. Their support for the Washington State Public Health Advisory Board's (PHAB) COVID-19 After-Action Report also ensured that key hospital priorities were emphasized in the state's plan for future public health emergencies.
The Future of Washington Healthcare
As the WSHA moves into the 2025 legislative session, its mission remains clear: to ensure all of Washington’s diverse communities have access to high-quality and equitable health care. The organization's success in achieving its legislative and financial goals—especially securing the Medicaid Professional Provider Rate Increase and protecting essential Rural Labor and Delivery Funding—will directly determine the financial stability of the state's healthcare providers. Entities like the Hospital Directed Payment Program, which the WSHA helped secure, are vital for providing financial relief to struggling facilities.
The WSHA's continuous advocacy against federal threats, such as potential cuts to Medicaid, further demonstrates its role as the primary defender of the state’s healthcare interests. By focusing on workforce development through the Rural Nurse Education Program and expanding behavioral health capacity, the Washington State Hospital Association is not just reacting to crises but actively building a more resilient, sustainable, and patient-centered healthcare system for the future.
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