A Mixed Bag for Kidney Patients in Olympia: 2025 Legislative Recap

The Washington State Legislature wrapped up its 2025 session with some important wins for kidney patients, dialysis providers, and the broader chronic disease community. While not every bill the Northwest Kidney Council supported made it across the finish line, there were meaningful steps forward — and momentum to build on heading into 2026 and beyond.

A Win for Primary Care Investment

One of the most promising outcomes of the session was the passage of SB 5084, which Governor Ferguson signed on April 4. This bill directs the state to dig deeper into how much is being spent on primary care and whether those dollars are being used effectively. This policy is a smart step toward a more transparent and accountable healthcare system — something that’s especially important for patients managing complex, chronic conditions like kidney disease.

Medicaid Reimbursement Reform Continues

HB 1392, which creates the Medicaid Access Program, passed the Legislature this year, and Governor Fergus signed the legislation on May 20. While Medicare is the primary payer for dialysis coverage, some kidney patients rely on Medicaid to help cover the cost of their  care. This legislation increases Medicaid professional services rates for specialty physicians (nephrologists), physician extenders, and others, up to Medicare rates. Assuring adequate reimbursement for these health care professionals is essential for maintaining access to specialty care for Washingtonians living with kidney disease. Even if this legislation is signed by Governor Ferguson, it will take authorization by the federal government to make it a reality.

We’re also grateful to our partners that answered the call to support continued funding for the Kidney Disease Program and preserve the increase in Medicaid reimbursement rates for dialysis providers through SB 5167, the biennial budget bill. These are essential steps to improving access to kidney care throughout the state.

Promising Ideas, But Delayed Progress

While we saw some key wins, some of the most innovative and patient-centered proposals unfortunately stalled this session.

• HB 1238 / SB 5064, which would have created a Rare Disease Advisory Council, were sidelined due to cost concerns.

• HB 1326, which aimed to improve access to diabetes prevention and obesity treatment, also ran into budget constraints. However, $250,000 in funding was included in the final budget to allow the Office of the Insurance Commissioner, in consultation with the Health Care Authority, to study the cost of implementing diabetes prevention and obesity treatment benefits — an important first step.

• HB 1262, which sought to expand and rename the Governor’s Council on Health Disparities, stalled over disagreements about scope.

  
  

While these bills didn’t move forward in 2025, the groundwork has been laid for future conversations and improvements.

A popular, commonsense proposal, requested by Governor Ferguson, (HB 1404/SB 5352), would have provided universal free breakfast and lunch school meals. It failed to progress due to cost concerns in a year where the Legislature had to deal with an unprecedented $16 billion shortfall.

Also failing to progress were Medigap access bills (HB 1603 & HB 1754). HB 1603 would have required guaranteed issue of Medicare supplemental coverage to an individual who voluntarily disenrolls from a Medicare advantage plan and enrolls in Medicare parts A and B. HB 1754 would have required Medicare supplemental insurance to be offered on a guaranteed issue basis during an open enrollment period.

Despite strong support and powerful testimony, both bills failed to progress because of concerns expressed by the Office of the Insurance Commissioner that their passage would result in increases to Medigap rates.

We know from our community that the ability to access Medigap insurance is very important to improving outcomes for patients for kidney disease. The Medigap access bills that failed would have removed some key obstacles, and we will continue to advocate for them in 2026.

Looking Ahead

This year’s session made it clear: thanks to our collective efforts lawmakers in Olympia are increasingly aware of the needs of kidney patients and others living with chronic conditions. We’ll be back in 2026 advocating for legislation that improve the lives of people with kidney disease — and we’ll be asking for your help. Whether it’s sending a letter, testifying, or sharing your story, your voice can make all the difference. And remember that legislation that failed to cross the finish line in 2025, will be alive again in 2026.