Following last week’s budget releases, lawmakers must now negotiate a compromise and they have until April 27 to figure it out. Several high-priority bills are also continuing to move through the Legislature, with the next deadline arriving Wednesday, April 2, when most bills will need to pass through policy committees in the opposite chamber.
SB 5796: Enacting an excise tax on large employers on the amount of payroll expenses above the social security wage threshold to fund programs and services to benefit Washingtonians
This is the employer payroll tax bill. It would impose a 5% tax on the amount of payroll expenses above the Social Security threshold — currently $176,100 per year — for companies with $7 million or more in payroll expenses. This would impact all hospitals in Washington State. Other employers with highly-skilled employees can move those employees out of state to avoid this tax. Physicians, experienced nurses and pharmacists cannot provide care in Washington hospitals from another state.
Annual state revenue from tax: $2.3 billion
Estimated annual hospital impact: At least $165 million
This bill has a hearing in Senate Ways and Means Committee at 4 p.m. today, March 31, 2025. WSHA will testify in opposition. (Ashlen Strong)
HB 2045: Investing in Washington families by restructuring the business and occupation tax on high grossing businesses and financial institutions
This measure adds an additional 1% B&O tax on taxable revenue above $250 million. All qualifying Washington State businesses would pay this tax. Hospitals deduct Medicare and Medicaid net revenue to calculate taxable revenue. For hospital taxable revenue below $250 million, the B&O tax rate remains 1.5%. For hospital taxable revenue above $250 million, the tax rate becomes 2.5%. Each legal entity pays the tax, so a system with several hospitals under one legal entity can only deduct the first $250 million from taxable revenue for the entire system. This bill would have a significant impact on hospitals and health systems that meet the taxable revenue threshold.
Annual state revenue from tax: $2 billion
Estimated annual hospital impact: At least $109 million
This bill has a hearing scheduled for April 3 in the House Committee on Finance at 8 a.m. WSHA will testify in opposition. (Ashlen Strong)
HB 2051: Concerning payment to acute care hospitals for difficult to discharge Medicaid patients
WSHA opposes HB 2051, which modifies existing law and removes language that requires the state Health Care Authority and managed care organizations to pay hospitals for ancillary services for Medicaid patients who no longer need acute, hospital-level care. WSHA successfully sought payment for ancillary services a couple of years ago with legislation sponsored by Sen. Muzzall. WSHA opposes HB 2051 because it adds another cost to hospitals that is not reimbursed.
The bill, introduced March 24, is deemed necessary to implement the budget and is exempt from regular deadlines. The House Committee on Appropriations will hold a public hearing on HB 2051 Thursday, April 3, and WSHA will testify in opposition. (Andrew Busz)
WSHA weighing in: March 31-April 4
Monday, March 31
- Senate Ways & Means
- SB 5796: Enacting an excise tax on large employers on the amount of payroll expenses above the social security wage threshold to fund programs and services to benefit Washingtonians. (Ashlen Strong)
Wednesday, April 2
- House Appropriations
- SB 5079: Addressing the burden of unintentional overpayments on older adults and adults with disabilities served by the department of social and health services. (Zosia Stanley)
- SSB 5568: Updating and modernizing the Washington state health plan. (Remy Kerr)
Thursday, April 3
- House Appropriations HB 2051: Concerning payment to acute care hospitals for difficult to discharge Medicaid patients. (Andrew Busz)
- SSB 5124: Establishing network adequacy standards for skilled nursing facilities and rehabilitation hospitals. (Zosia Stanley)
- SB 5463: Concerning the duties of industrial insurance self-insured employers and third-party administrators. (Remy Kerr)
- House Finance
- HB 2045: Investing in Washington families by restructuring the business and occupation tax on high grossing businesses and financial institutions. (Ashlen Strong)
- Senate Ways & Means
- E2SHB 1686: Creating a health care entity registry. (Katerina LaMarche)
- 2SHB 1162: Concerning workplace violence in health care settings. (Remy Kerr)
- SHB 1392: Creating the Medicaid access program. (Andrew Busz)
Friday, April 4
- House Appropriations
- ESSB 5041: Concerning unemployment insurance benefits for striking or lockout workers. (Remy Kerr)
- SSB 5394: Reducing the developmental disabilities administration’s no-paid services caseload services. (Zosia Stanley)
- Senate Ways & Means
- SHB 1272: Extending the program to address complex cases of children in crisis. (Cara Helmer)
- E2SHB 1432: Improving access to appropriate mental health and substance use disorder services. (Cara Helmer)
