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Toppenish hospital leaders urge Legislature to equalize Medicaid payments
Summary
Health system leaders and hospital executives testified in favor of Senate Bill 6,194, saying Toppenish Hospital needs cost‑based Medicaid reimbursement to remain solvent after losing enhanced payments in 2021 and to preserve care for Yakama Nation and agricultural communities.
Committee staff described Senate Bill 6,194 as narrowly targeted legislation to allow Medicaid payments based on allowable costs for a rural hospital located on a federally recognized Indian reservation — in practice, Toppenish Hospital.
Sandy Stith, staff to the committee, said the bill would allow allowable‑cost payments beginning in a future fiscal period (staff noted implementation timing may require a January 1, 2027 start) and summarized fiscal estimates in the fiscal note. “The costs are $2,900,000 general fund state for 2027, total cost of $9,400,000,” Stith said, and provided the broader 2027–29 estimates from the fiscal note.
Kathy Bambrick, CEO of Astria Toppenish Hospital, and Eric Jensen, executive director of governmental affairs for Estrella Health, described the hospital’s operating shortfalls after the loss of enhanced Medicaid reimbursement and pandemic‑era cost pressures. Bambrick said the hospital had closed obstetric services in 2022 and discontinued its MRI in late 2023; she framed SB 6,194 as a health‑equity remedy for a community with a high share of Yakama Nation and Hispanic residents.
Eric Jensen provided specific figures on reimbursement shortfalls, saying Medicaid paid only about 8.3% of Toppenish Hospital’s charges for care in 2024 while comparable critical access hospitals were paid a higher share; he said Medicaid paid roughly $5.2 million to the hospital in 2024 while costs were approximately $14.7 million, producing multi‑million dollar operating losses.
Physicians and system leaders — including Raul Garcia, medical director, and Brian Gibbons, president and CEO of SeaMar Health — urged the committee to equalize Toppenish reimbursement to critical access hospital levels to preserve acute care in the region.
The public hearing record closed without a committee vote that night; staff noted the Health Care Authority expects implementation timing considerations.
