2025 End of Session Report

The Washington State Legislature adjourned sine die (a Latin phrase meaning "without a day to reconvene") on Sunday, April 27, 2025 closing out a tumultuous and emotionally charged session marked by significant political tension, major fiscal challenges, and the deaths of two legislators. From the opening days, the atmosphere was fraught with division. Deep ideological splits over how to address the state’s financial crisis created an environment in which lawmakers frequently clashed not only along party lines but also within their own caucuses.

The primary focus of the 2025 legislative session was how to address the enormous budget shortfall. WSNA and many other labor and health and human service organizations asked for minimal cuts and more progressive revenue. The final operating budget for the next biennium that was passed totaled $77.9 billion and increased investments in K-12 education while maintaining savings in the state’s “Rainy Day” fund. It included ~$2.7 billion in cuts and ~$4.3 billion in revenue to balance the budget shortfall. The new revenue primarily comes from businesses, financial assets, and technology services. Read a detailed breakdown of the new state budget on Cascade PBS.

Below is a report of the “2025 Operating Conference Budget,” or the final budget, broken down by agency and areas of interest relevant to healthcare and labor as identified by WSNA Government Affairs. Additionally, in this wrap up document, you will find a report of how each of WSNA’s legislative priorities fared this session, as well as updates on a number of other bills we weighed in on throughout the session.

If you have questions about any of this information or other areas of the budget, you may contact us at GOVA@wsna.org.

Healthcare and Labor budget items of interest

All dollars reflect General Fund – State operating funds and any additional noted in description.

School Nurses of Washington (SNOW) budget items of interest

The following five priorities were decided upon by WSNA's Legislative & Health Policy Council (LHPC). Learn more about how legislative priorities are determined.

Workplace violence in healthcare settings

2SHB 1162 PASSED

In 2019, the Legislature passed a law on workplace violence (WPV) in hospitals requiring them to develop safety plans once every three years, safety trainings for employees, and an annual review of WPV related incidents. This work is carried out by WPV or safety committees established pursuant to RCW 49.17.050. HB 1162 takes the work being done by these WPV/safety committees to the next natural step by requiring a more regular and detailed analysis of WPV incident-related data by the committee, as well as required reporting of this data within the committee and annual updates to the safety plan based on this regular analysis of data. Our focus is on prevention, and our goal is to move the needle on WPV, as it has been trending upwards steadily over the last several years. Governor Ferguson signed the bill into law on Saturday, May 17, 2025.

Effective Date

January 1, 2026

Next Steps

L&I will work to revise and update the existing RCW 49.19 with the new language over the months following the passage of this law. Once that has been done, WSNA Government Affairs will work with Nursing Practice to update our member supporting materials on this new law. Explore WSNA’s current resources on workplace violence and RCW 49.19.

Unemployment insurance for striking or lockout workers

ESSB 5041 PASSED

This bill will help level the playing field, discourage economic hardship as a bargaining strategy, and promote good-faith contract negotiations. It allows individuals unemployed due to a labor strike to receive unemployment insurance (UI) benefits following a specified disqualification period and the waiting week, provided that the labor strike is not found to be prohibited by federal or state law in a final judgment. Limits the number of weeks a striking worker may receive UI benefits to six (6) weeks. It removes the provision disqualifying an individual for UI benefits based on an employer-initiated lockout resulting from a strike against another employer in a multi-employer bargaining unit. It requires the Employment Security Department to provide an annual report to the Legislature regarding the prevalence of strikes and the impact on the UI Trust Fund. Provides a ten-year sunset for the act.

SB 5041 was introduced in the Senate Labor Committee and has been amended throughout the House and Senate. House and Senate had to concur on the final version of the bill as described above. Governor Ferguson signed the bill into law on Monday, May 19, 2025.

Effective Date

January 1, 2026

Next Steps

L&I will work to revise and update the existing RCWs with the new language over the months following the passage of this law. Once that has been done, WSNA Government Affairs will work to post supporting materials on this new law.

Mergers and acquisitions in healthcare

HB 1881 / SB 5704 DEAD

Mergers and acquisitions between healthcare entities are prolific in Washington state. Now we are seeing private equity and hedge funds move into the healthcare space. Data shows that these transactions can negatively impact cost, quality, and access to necessary healthcare services, including protected healthcare services and healthcare affordability. Yet in Washington, these health entity consolidations receive minimal oversight, allowing large healthcare systems to dominate the market and dictate patients’ access to care and affordability. Nurses have seen time and again that this results in a reduction in staffing, support, and resources, or the complete elimination of lines of services. HB 1881 provides public oversight on accessibility and affordability of services and to ensure mergers, acquisitions, and contracted affiliations do not result in reduced access to quality, affordable care and services.

Requires filing of notice at least 90 days before a qualifying material change transaction among health care market participants, extends material change transactions to cover additional parties, and requires notices to include additional information. Requires the Attorney General to determine whether a specific transaction is a material change transaction, grant or deny applications for emergency notice and review, determine if a notice filing is complete, and publish notice information. Prohibits material change transactions that would detrimentally affect accessible, affordable health care in Washington for at least five years, and requires material change transactions to result in affected communities having the same or greater access to quality affordable care, including emergency care, primary care, specialty care, behavioral health care, reproductive health care, gender-affirming care, end-of-life care, and essential health benefit categories. Requires the Health Care Authority, for certain material change transactions, to review notice information; hold at least one public hearing; conduct an Access, Affordability, Quality, and Equity Review; and issue a report and recommendation to the Attorney General. Requires the Attorney General, for certain material change transactions, to approve, approve with conditions or modifications, or reject the transaction, subject to judicial review; monitor compliance once a transaction is complete; and investigate post-transaction violations and issue orders to bring parties or successors into compliance. Allows parties to designate certain documents as confidential, requires parties to provide redacted and non-redacted versions of such documents, and requires the Health Care Authority and Attorney General to maintain confidential documents as confidential.

BEST mentor program for novice school nurses

SB 5270 / HB 1352 DEAD

School nurses provide direct care, care coordination, and case management to Washington state students. Their work and presence are essential for students to benefit from their education programs, especially students impacted by academic inequities and complex health conditions. While nurses are typically trained to provide care to patients in hospitals and clinic settings, school nurses practice in non-health settings with work crossing both the education and health sectors. This can lead to professional isolation, so feeling supported is key to retention. The Beginning Educator Support Team (BEST) is a grant program established to support novice educators and other professionals that work in Washington State’s school districts. This program helps support and retain professionals in our public education system by providing them with a mentor and support system. The mentorship opportunity will be available to all novice school nurses regardless of ESA certification or size or class of district. The goal is to improve retention of school nurses and improve health services to students.

HB 5270 requires school districts receiving funding for the Beginning Educator Support Team Program to prioritize and provide a mentor to any novice school nurse employed by the district. Defines novice school nurse as a registered nurse or advanced registered nurse practitioner who is in their first, second, or third year in a school-based role.

Equal reimbursement for services provided by ARNPs

EHB 1430 DEAD

This bill would require commercial insurance plans to reimburse ARNP and PA care at the same rate as physicians for the same services provided. Currently, commercial health plans withhold up to 15% of the reimbursement for services provided by advanced registered nurse practitioners (ARNPs) and physician assistants (PAs). These insurance plans keep this as profit instead of using it to reduce premiums paid by patients and employers. This reduced reimbursement has led to clinic closures and reduces patient access to much needed care. Currently WA State Medicaid and WA Labor and Industries (L&I) reimburse ARNPs and PAs at 100% of the physician rate for the same services provided.

In addition to our own legislative priorities, WSNA also tracks and weighs in on other bills that are introduced throughout the legislative session that may impact our members directly or the quality of patient care and access. Below are some of those bills that WSNA weighed in on either in support, opposition, or simply monitored for one reason or another. These bills are not presented in any particular order, nor is it the complete list of all bills we tracked this past session.

Concerning meal and rest breaks for hospital workers

SHB 1879 PASSED

This bill allows a hospital employer and employee to mutually agree to waive a meal or rest period and the timing of those periods, subject to certain conditions.

Concerning appropriate response to assaults by individuals in behavioral health crisis

HB 1220 DEAD

This bill would create an exception for assaults in the third degree on nurses, physicians, and other health care providers when that assault is carried out by someone detained or pending an evaluation for detention for behavioral health disorders; receiving or in the process of seeking voluntary inpatient psychiatric treatment; or detained for behavioral health treatment pursuant to the laws on criminal insanity. This exception would apply only to health care workers, not to any other occupational category included in RCW 9a.36.031 such as police officers, firefighters, or transit workers. HB 1220 is far too broad in its reach and would send a message devaluing the safety of nurses, physicians, and other healthcare workers. It would detract from efforts to enhance healthcare workplace safety.

WSNA had phenomenal engagement on this bill – more than 500 nurses engaged and emailed their representatives within 24 hours asking them to oppose this bill and why it was bad for nurses. This resounding engagement helped keep this bill from being heard and passed, but this is likely not the last we’ve heard of it. WSNA plans to engage with the bill’s prime sponsor over the interim to discuss the issue.

Allowing bargaining over matters related to the use of artificial intelligence

ESHB 1622 DEAD

Requires certain public employers to bargain over the decision to adopt, or modify current uses of, artificial intelligence technology if the adoption or modification affects employee wages or performance evaluations. It died in the Senate fiscal committee largely due to fiscal note.

Creating a homes for heroes program

SHB 1022 DEAD

Creates a down payment and closing cost assistance program for people who work in targeted professions (nurses, firefighters, etc.) and meet certain income requirements.

Providing coverage for biomarker testing

HB 1062 DEAD

Requires coverage for biomarker testing under certain circumstances.

Allowing collective bargaining over contributions for certain supplemental retirement benefits

HB 1069 / SB 5044 DEAD

Allows bargaining under the Personnel System Reform Act over contributions for supplemental retirement benefits, including medical plans, administered by, or on behalf of, an employee organization.

Raising awareness of pain control options for intrauterine device placement and removal

HB 1077 DEAD

Requires health care providers to notify patients seeking intrauterine device placement or removal of the types of pain control options available.

Concerning health plan coverage of fertility-related services

SHB 1129 / SSB 5121 DEAD

Requires large group health plans and health plans offered to public employees to cover standard fertility preservation services beginning January 1, 2026, and diagnosis and treatment for infertility beginning January 1, 2027. Requires Medicaid to cover standard fertility preservation services.

Prohibiting noncompetition agreements and clarifying non solicitation agreements

SHB 1155 / SB 5437 DEAD

Makes any noncompetition covenant void and unenforceable, regardless of when the parties entered into the covenant.

Expanding the situations in which medications can be dispensed or delivered from hospitals and health care entities

SHB 1186 PASSED

Authorizes hospitals and health care entities to dispense or distribute medications in additional circumstances.

Expanding protections for workers in the state paid family and medical leave program

E2SHB 1213 PASSED

Lowers the employer size threshold for employment protection rights in the Paid Family and Medical Leave (PFML) Program and provides an employee with protection if he or she began employment with a qualifying employer at least 180 calendar days before taking leave. Allows employers to prevent stacking of certain employment protection rights by extending employment protection in the PFML Program to periods of unpaid leave protected by the federal Family and Medical Leave Act, so long as the employer provides certain notices to the employee, and providing that employment protection expires after certain periods. Expands health care coverage protection during any period in which an employee receives PFML Program benefits and is also entitled to employment protection. Expands access to grants for small employers to offset the costs of employees' use of leave in the PFML Program.

Concerning access to personnel records

SHB 1308 PASSED

Requires a private employer to provide an employee or former employee with a copy of the employee's personnel file within 21 days of a request, and requires a public employer to do so in accordance with the requirements and procedures of the Public Records Act. Requires a private employer to provide to a former employee, upon request, a statement of the employee's discharge date and reasons, if any, for the discharge. Creates a private cause of action with statutory damages for enforcing the requirements for private employers to disclose personnel files and provide written discharge statements.

Preserving the ability of public officials to address communicable diseases

ESHB 1531 PASSED

Requires public health responses to communicable diseases to be guided by the best available science.

Concerning the licensure of health care administrators

HB 1567 DEAD

Establishes licensing requirements for health care administrators who are: (1) nonclinical hospital managers with direct supervisory authority over clinical health care providers; and (2) nonclinical hospital directors, officers, and executives with supervisory authority for those nonclinical hospital managers who have direct supervisory authority over clinical health care providers. Establishes acts of unprofessional conduct specific to licensed health care administrators related to supervision and fiscal and operational decision making.

Creating a health care entity registry

E2SHB 1686 PASSED

Requires the Department of Health, in consultation with others, to develop a plan and provide recommendations to the Legislature on how to create a complete and interactive registry of the health care landscape in Washington.

Concerning labor standards

HB 1764 / SB 5578 DEAD

Increases the minimum wage for employees beginning January 1, 2026. Requires employers and transportation network companies (TNCs) to provide paid vacation leave to employees or drivers at a rate of 2.3 hours of paid vacation leave for every 40 hours worked. Entitles an employee to at least five days of paid bereavement leave per calendar year if an employee's family member dies. Allows the Department of Labor and Industries to issue a stop work order to cease all business operations where the violation occurred and require the employer or TNC to pay workers normal compensation for regularly scheduled hours, if an employer or TNC violates this act.

Concerning county property tax levels for public health clinic purposes

HB 1870 / SB 5709 DEAD

Allows counties to levy a property tax of up to 5 cents per $1,000 of assessed value for public health clinics.

Regulating tobacco and nicotine products

HB 2068 / SB 5803 DEAD

Prohibits the sale, display, marketing, or advertising of any flavored tobacco or nicotine product or entertainment vapor product. Requires signage regarding the new prohibitions, a prevention and awareness campaign by the Department of Health, and provides for tribal consultation. Increases license fees and administrative penalties for cigarette, tobacco product, and vapor product licensees. Makes it a gross misdemeanor to sell or give an alternative nicotine product to a person under age 21, defines alternative nicotine products, and re-defines tobacco product. Makes it unlawful to sell, give, deliver, or furnish to a person a product that contains a nicotine analogue, and defines nicotine analogue. Adds an additional cigarette tax of $2 per pack of cigarettes, to be adjusted every three years for inflation. Adjusts the tax on vapor products, tobacco products, and alternative nicotine products to be 95 percent of the taxable sales price. Makes additional changes to tobacco and vapor product laws.

Concerning health care coordination regarding confined individuals

SSB 5031 DEAD

Creates a health care coordination council within the Department of Health, to improve communication and coordination between health care programs for those in confinement settings.

Allowing collective bargaining over contributions for certain supplemental retirement benefits

SB 5044 / HB 1069 DEAD

Requires bargaining under the Personnel System Reform Act over contributions for supplemental retirement benefits, including medical plans, administered by, or on behalf of, an employee organization.

Expanding access to leave and safety accommodations to include workers who are victims of hate crimes or bias incidents

SSB 5101 PASSED

Expands the protections of the Domestic Violence Leave Act to employees who are, or whose family members are, victims of hate crimes.

Prohibiting the sale of certain tobacco and nicotine products

SB 5183 / HB 1203 DEAD

Prohibits the sale, display, and advertisement of any flavored tobacco, nicotine, or vapor product and any entertainment vapor product. Requires a prevention and awareness campaign, requires signage, imposes penalties, specifies enforcement provisions, applies the Consumer Protection Act, and authorizes tribal consultations.

Expanding pregnancy-related accommodations

E2SSB 5217 PASSED

Modifies the definition of employer for purposes of pregnancy and pregnancy-related accommodation. Requires an employer to pay an employee for break and travel time to express milk during work at the employee's regular compensation rate, in addition to meal and rest periods. Transfers investigative and enforcement authority for complaints of failure to provide pregnancy-related accommodations to the Department of Labor and Industries. Allows a person with an infant under 12 months old to request a delay or excusal from jury service if the person is unable to serve due to having an infant under 12 months old.

Concerning emissions of greenhouse gases used for anesthetic purposes

SSB 5236 DEAD

Directs the Department of Ecology (Ecology) to commission a study, to be completed by July 1, 2026, relating to the use of certain gases used for anesthetic purposes—anesthetic gases. Requires Ecology, in consultation with the Washington State Department of Health (DOH), to report to the Legislature on statutory changes necessary to reduce greenhouse gas (GHG) emissions from using anesthetic gases by January 1, 2027. Requires Ecology, in consultation with DOH and other specified organizations, to develop and publish a guidance document intended to reduce GHG emissions from using anesthetic gases in certain medical settings by April 1, 2027. Provides that, beginning January 1, 2028, facilities and practitioners in certain medical settings may only use anesthetic gases consistent with the guidance document, with certain exceptions.

Concerning the corporate practice of health care

2SSB 5387 / HB 1675 DEAD

Prohibits the corporate practice of health care except through a professional service corporation or limited liability company. Prohibits individuals not licensed to practice a health care profession from interfering with the clinical decision-making of health care providers providing care at licensed facilities.

Concerning employment loss due to businesses closing or mass layoffs

ESSB 5525 PASSED

Requires, with some exceptions, employers with 50 or more employees to provide 60 days' notice to their employees prior to a business closing or mass layoff.

Codifying emergency rules to protect the right of a pregnant person to access treatment for emergency medical conditions in hospital emergency departments

ESSB 5557 PASSED

Requires hospitals, when providing emergency services, to provide treatment to a pregnant person who comes to the hospital with an emergency medical condition that is consistent with the applicable standard of care for such condition or, if authorized, to transfer the patient to another hospital capable of providing the treatment, with the patient's informed consent.

Reducing environmental and health disparities and improving the health of Washington state residents in large port districts

SB 5652 / HB 1948 DEAD

Requires a qualifying port district to include an environmental justice implementation plan within its strategic plan. Specifies that a qualifying port district must create and adopt a community engagement plan. Specifies certain actions a qualifying port district must take to assess and mitigate environmental impacts of significant port actions.

Concerning Universal Health Care

SJM 8004 PASSED

Requests the federal government to create a universal health care program, partner with Washington to implement a single-payer health care system or remove federal restrictions on Washington's ability to create a universal health care system.