Grassroots Update: Medicaid Rates Advocacy Starts with Understanding the State Operating Budget

In mid-September, DSHS submitted “decision package” recommendations to the Governor’s budget office, the Office of Financial Management, for consideration in Washington’s FY25-27 operating budget. This budget will impact Medicaid rates from July 1, 2025-June 30, 2027: The DSHS proposals underscore the need for additional funding for Medicaid care in skilled nursing and assisted living—and this is important information for advocates. These proposals are only the first step in a protracted budget development process, but it does set the stage for our future work. Here are details about how the state operating budget is developed and adopted.

DSHS has advanced these recommendations for assisted living and skilled nursing facility funding for the 2025-2027 state operating budget.

• Assisted Living Medicaid Funding: ALTSA requests a total of $97.9 million to support the viability of assisted living providers by increasing the labor component from 81.7 to 95 percent of estimated labor costs and increasing the AL operations component from 68 percent to 75 percent. The Department allocates $43.9 million to rebase rates in the second year of the biennium through the maintenance level budget. The rebase would go into effect on July 1, 2026.
• SNF Medicaid Funding: For FY 2026 (first year of the biennium) DSHS requests $74.5 million to hold rates to FY 25 levels. DSHS also requests $102.8 million for FY 2027 rates rebase.

From here, Governor Inslee’s Office of Financial Management will review hundreds of agency proposals for consideration in the current Governor’s state budget. While Governor Inslee’s term will be over in January, his plan will still be released in December—and the House and Senate will follow with proposals in early 2025.  It will be critical for our members to engage with policymakers throughout the budget development process. The Department’s proposals clearly support additional funding.

This is where grassroots advocacy is critical:

If you are a skilled nursing facility or assisted living provider with a passion for your work, and a desire to help advocate for fair and adequate funding—we need you! Please reach out to Eric Negomir so that he can help you get dialed in on the advocacy process, and on your role to help educate policymakers. He’s committed to empowering your work as an informed, effective advocate and has resources available to help you shine in this important role!