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Lawmakers hear arguments for and against pay-parity bill for APRNs and physician assistants
Summary
The House Health Care & Wellness Committee heard broad public testimony on House Bill 1430, which would require private health carriers to reimburse contracted APRNs and PAs at no less than the amount paid to contracted physicians for the same service in the same service area.
The House Health Care & Wellness Committee heard extensive public testimony on House Bill 1430, a proposal that would bar private health carriers from reimbursing contracted advanced practice registered nurses (APRNs) or physician assistants (PAs) at a lower rate than contracted physicians for the same service in the same service area for plans issued or renewed on or after Jan. 1, 2026.
Staff described the bill's scope: it would not permit insurers to reduce physician reimbursement to meet parity and would not apply to APRNs or PAs employed by health maintenance organizations; it would also require the Office of the Insurance Commissioner to report by July 1, 2027 on the policy's impacts on reimbursement and costs.
Prime sponsor Representative Tara Simmons, a former registered nurse, framed HB 1430 as a workforce and access bill. "They have been vital members of our workforce," Simmons said, and she argued evidence shows care quality and outcomes by nurse practitioners and PAs are equivalent to physicians in many settings. Supporters told the committee that reductions by commercial insurers in recent years (from about 100% to roughly 85% of physician rates) have contributed to clinic closures, fewer providers accepting insurance and reduced access, especially in rural areas.
Nurse practitioners, physician assistants and allied professional groups provided much of the in-person and remote testimony. Louise Kaplan, a family nurse practitioner and member of ARNPs United, said the reduced reimbursement "makes it difficult for practices to remain financially solvent" and urged the committee to restore reimbursement to prior levels. Testimony from rural practice owners and clinicians described clinics that closed or reduced services after reimbursement cuts.
Opposition came from insurers, some medical groups and small-business representatives. Jennifer Ziegler of the Association of Washington Healthcare Plans cautioned that mandating parity in the commercial market could raise premiums; she noted individual-market premium increases in recent years and urged lawmakers to consider the bill's effect on premiums. The Washington State Medical Association said carriers should have latitude to set contracted rates across professions, citing differences in education, training and practice scope; a medical-student testifier said parity could disincentivize pursuing a physician pathway.
Other witnesses, including labor, nursing and rural-health advocates, argued parity would improve network stability and rural access; researchers presented evidence that equivalent reimbursement in the state's workers' compensation system had increased availability of ARNP providers without raising costs within that system.
The committee heard many personal accounts of clinics that reduced services or closed in part because of reimbursement cuts, and several witnesses urged a targeted approach to support providers in underserved specialties and areas. No committee vote was taken during the hearing; participants and sponsors indicated follow-up work on targeted carve-outs and data-reporting language would continue.
