Hearing: bill would peg tribal‑reservation rural hospital payments to allowable costs for Toppenish Hospital
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Summary
Committee heard testimony supporting Senate Bill 6,194 to align Medicaid reimbursement for Toppenish Hospital (located on a federally recognized Indian reservation) with allowable‑cost payments used for critical access hospitals; hospital leaders described service closures and large operating losses.
Senate Bill 6,194 would permit Medicaid payments based on allowable costs for a rural hospital located on a federally recognized Indian reservation, specifically the Toppenish Hospital, with an anticipated implementation timeline and material fiscal implications.
Sandy Stith, staff to the committee, said the bill would allow payments based on allowable costs for inpatient and outpatient services for a hospital located on reservation land and noted estimated general‑fund costs in staff materials (examples: $2.9 million GF state in 2027; larger total fund impacts over the outlook period). Stith also said the Health Care Authority believed the bill may need to start on Jan. 1, 2027.
Hospital leaders and community health representatives testified the hospital has lost enhanced Medicaid reimbursement previously available to similar rural hospitals and is operating under severe financial strain. Kathy Bambrick, CEO of Toppenish Hospital, described closures including obstetrics (closed 2022) and the discontinuation of the hospital’s MRI service, saying the community depends on the hospital and urging the legislature to pass SB 6,194 to “preserve healthcare access and correct the health inequity faced by the Toppenish community.”
Eric Jensen of Estrella Health provided numerical detail on payment gaps: he said Medicaid paid the hospital only about 8.3% of charges for care in 2024, while critical access hospitals in other regions were paid a materially higher percentage; he summarized a roughly $9.5 million gap between Medicaid payments and the hospital’s acute‑care costs in 2024, comparable to recent annual operating losses.
Clinicians and local leaders emphasized the hospital’s role serving Yakama Nation members and farmworker communities and urged equitable funding. Staff presented fiscal notes with multi‑year cost estimates and noted the bill’s scope is limited to Toppenish Hospital.
Next steps: No committee action was taken that night; staff and sponsors may adjust effective dates and technical language before further consideration.
