HB 2555
In CommitteeHouse
Traditional health/medicaid
Concerning medicaid coverage for traditional health care practices.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill allows Washington’s Medicaid program to cover traditional Indigenous health practices—such as herbal medicine, spiritual healing, and other culturally based treatments—when provided by federally recognized tribal or urban Indian health programs. It requires the state to seek federal approval to include these services in Medicaid coverage.
- Requires the Health Care Authority to apply for a federal Section 1115(a) waiver by July 1, 2026 to allow Medicaid coverage of traditional health care practices.
- Authorizes Medicaid coverage of traditional health care practices when delivered by Indian Health Service facilities, tribally operated facilities under the Indian Self-Determination Act, or urban Indian organization facilities under Title V of the Indian Health Care Improvement Act.
- Limits coverage to Medicaid beneficiaries who receive services through those approved facilities.
- Expands the definition of traditional health care practices to include Indigenous knowledge, skills, and treatments used for physical and mental health maintenance and care.
- Requires coverage to comply with Centers for Medicare & Medicaid Services (CMS) requirements and federal law.
Who is affected
- American Indian and Alaska Native individuals — American Indian and Alaska Native individuals who receive care through tribal or urban Indian health programs may gain access to covered traditional health services under Medicaid, improving access to culturally relevant care.
- Tribal and urban Indian health providers — Tribal health programs, urban Indian organizations, and Indian Health Service facilities may be able to bill Medicaid for providing traditional health care services, increasing funding and sustainability.
- Washington State Health Care Authority — The Washington State Health Care Authority will be responsible for applying for a federal waiver and managing coverage of traditional health practices under Medicaid.
- State of Washington (fiscal operations) — State government may see changes in Medicaid spending due to increased federal matching funds for traditional health services, potentially reducing state general fund costs.
Pro/Con Analysis
Stronger case for concerns
Potential Benefits (5)
The bill may reduce out-of-pocket costs and improve continuity of care for AI/AN Medicaid beneficiaries by covering traditional healing practices that align with their cultural values—potentially improving mental health, substance use outcomes, and trust in the health system.
HealthcarePeopleRef: Sec. 2 (new), p. 5State savings generated from 100% federal matching funds may be reinvested in community health infrastructure, including tribal health programs, though the bill does not mandate how savings are used—leaving room for equitable reinvestment.
Local GovernmentPeopleRef: Sec. 2 (new), p. 5; Fiscal Impact sectionFormal recognition of Indigenous knowledge in law may support curriculum development in tribal colleges and health training programs, though the bill itself does not fund or mandate such education.
EducationPeopleRef: Sec. 1(16) (new definition)By integrating culturally grounded mental health and substance use interventions, the bill may reduce crisis-related emergency room visits and law enforcement encounters among AI/AN populations—though evidence of this effect is indirect and not quantified.
Public SafetyLean peopleRef: Sec. 2 (new), p. 5Improved mental and physical health outcomes from culturally appropriate care could indirectly support housing stability for vulnerable AI/AN populations, but the bill does not include housing-related services or funding mechanisms.
HousingLean peopleRef: Sec. 2 (new), p. 5
Potential Concerns (5)
The bill expands Medicaid coverage to include traditional Indigenous health practices—such as herbal medicine and spiritual healing—when delivered by federally recognized tribal or urban Indian health programs, improving access to culturally relevant care for American Indian and Alaska Native (AI/AN) Medicaid beneficiaries.
HealthcarePeopleRef: Sec. 2 (new), p. 5The bill enables 100% federal matching funds for covered traditional health services under CMS SHO 16-002, generating new state savings that reduce reliance on general fund dollars—this improves fiscal sustainability and redirects state resources toward broader public health needs.
HealthcarePeopleRef: Sec. 2 (new), p. 5; Fiscal Impact sectionBy formally including Indigenous knowledge and practices in the definition of “traditional health care practices,” the bill affirms tribal sovereignty in health and supports culturally safe care models that have historically been excluded from mainstream Medicaid coverage.
HealthcarePeopleRef: Sec. 2 (new), p. 5; Sec. 1(16) (new definition)Tribal and urban Indian health providers gain the ability to bill Medicaid for traditional services, potentially increasing funding and workforce sustainability for these community-based organizations—though this benefit is limited to those operating under federal contracts or grants.
Business & EmploymentPeopleRef: Sec. 2 (new), p. 5The expanded definition of “community health aide” to include behavioral health and dental aides strengthens the workforce pipeline for culturally competent care in tribal and urban Indian settings, improving service delivery capacity.
HealthcareLean peopleRef: Sec. 1(7)–(8) (definitions)
Who Is Most Affected
AI/AN individuals—especially those enrolled in Medicaid and accessing care through tribal or urban Indian health programs—will benefit most directly from expanded access to culturally aligned care. This group has historically faced barriers to culturally competent services and higher rates of preventable illness; this bill addresses systemic gaps in care access and trust.
Tribal and urban Indian health providers gain new billing authority and federal funding support, strengthening program sustainability and workforce retention. However, they must navigate federal waiver requirements and may face administrative burdens in implementation.
The Washington State Health Care Authority gains responsibility for waiver application and oversight but also benefits from increased federal funding and potential state savings. Its role is largely administrative and does not significantly shift power or resources away from tribal control.
The state as a whole benefits from improved fiscal efficiency (100% federal match) and reduced long-term health disparities, but non-AI/AN residents see little direct benefit. The policy does not impose new costs on the general public and may improve population health outcomes broadly.
Non-AI/AN Medicaid beneficiaries and general public see no direct benefit or burden; however, if state savings are reinvested in broader health infrastructure, there may be downstream positive spillovers. The bill does not reduce benefits or access for others.