Nurse Practitioner Reimbursement Parity Bill - 2025 Legislative Recap & What to Know about 2026

Reminder - What the Reimbursement Parity Bill Does:

HB1430 would require health insurance plans to reimburse nurse practitioners (NPs) and physician assistants (PAs) at the same rate as physicians when providing the same services. Since about 2013, many commercial insurers reimburse NPs at only 85% of what they pay physicians for identical care, which particularly impacts NP-owned practices and small practices, creating financial barriers to independent practice, as well as impacting access in general, but especially to the high-quality care NPs provide. Note, while Medicare also pays NPs/Pas 85% of physician pay, this bill does not address that because that is a federal issue.

The bill would apply to commercial insurance plans regulated by the state Insurance Commissioner. After amendments during last year's session, it no longer applies to state employee health plans (PEBB and SEBB), which was an intentional decision to reduce state costs and increase our success moving the bill forward. It would be an incremental move that could be built upon in the future.

Why It Matters to You:

For NP practice and small practice owners, this bill would directly increase revenue by eliminating the arbitrary reimbursement discount. For employed NPs, parity strengthens the value proposition of NP care and supports practice sustainability. The current payment differential has no clinical justification; it's simply a choice commercial insurers made over a decade ago that undervalues NP services despite equivalent care quality, and the insurers are keeping that 15%.

What Happened in 2025:

The bill made its furthest progress ever, passing through the House with strong support from prime sponsor Rep. Tarra Simmons, many other legislators, and the public. However, it stalled and died in the Senate Ways and Means Committee. Despite removing state employee plans from the bill's scope, the Health Care Authority (HCA) identified remaining costs to the state and potentially PEBB and SEBB recipients that proved too high given the severe budget deficit. In the context of tight fiscal constraints, legislators couldn't justify the expense. You can check out the fiscal note here: https://fnspublic.ofm.wa.gov/FNSPublicSearch/GetPDF?packageID=74538 

The Path Forward - 2026 and Beyond:

We are not moving the bill during this year's short legislative session. Here's why this strategic pause makes sense:

• The state faces a $2.3 billion budget deficit, exacerbated by December flooding costs
• Even with Governor Ferguson's creative and balanced approach (using rainy day funds, eliminating some tax breaks, considering a wealth tax, etc), the budget climate remains extremely challenging
• Any bill with associated state costs faces an uphill battle this year

Our focus for 2026:

Building relationships with legislators and government officials and laying groundwork for success in 2027 when budget conditions should improve. We will have to re-submit the bill in 2027, but we will be positioned to move quickly when the fiscal environment is more favorable.

What You Can Do:

Stay engaged with us and be ready to advocate when we reintroduce the bill. The groundwork laid in 2025 demonstrated strong legislative support; we just need better budget timing. Your stories about how reimbursement parity would impact your practice and patients remain crucial to eventual success, so please feel welcome to share that.

Bottom line:

This is a strategic delay, not a defeat. We're positioning ourselves for success when conditions allow.

In the meantime, I will send out any advocacy opportunities for other bills impacting NP care and will regularly keep you informed about what is happening in this short session (which ends 3/12).

Katie Wahler, DNP, MSN, FNP-C

MBNPA Legislative Liason