Senate approves cap on medical debt interest after debate over rural hospitals

The Washington State Senate passed Engrossed Substitute Senate Bill 5993 on Feb. 5, 2026, capping interest on medical debt after floor amendments and more than an hour of debate about the bill’s effect on rural hospitals and providers.

Senator Alvarado, the bill sponsor, told colleagues the measure “caps interest on medical debt at 1%,” describing the change as a compromise to help families manage bills without eliminating underlying obligations. She said the cap seeks to reduce the compounding burdens that push households toward bankruptcy: "Families want to pay their bills. They wanna pay the bill and recover and move on." (Sen. Alvarado)

Floor debate focused on trade-offs between consumer relief and maintaining financial viability for small and rural hospitals. Senator Wagner proposed an amendment to set higher interest allowances for providers—"allow, for smaller hospitals up to 4% interest and our larger conglomerates at 2%"—framing it as a measure to protect rural hospitals that face thin margins. Senator Short, representing a large rural district, urged support for Wagner’s approach, stressing that small hospitals could otherwise close and leave long travel distances for emergency care.

Lawmakers voted to adopt amendment number 0 5 4 0, which removed retroactive effect and made the bill effective Jan. 1, 2027. A later roll call on amendment 0 5 4 9, the differential-rate proposal, failed to earn majority support and the amendment was not adopted. The Senate also adopted amendment 0 5 3 7, described on the floor as a set of technical clarifications.

After debate and roll calls, the chamber reported the final tally as 29 yeas and 19 nays with one excused, and the engrossed substitute was declared passed. The bill’s reading noted that it would amend RCW provisions related to interest on medical debt.

Supporters said the 1% cap is intended to give families breathing room to repay necessary care without imposing excessive finance charges; opponents warned that too-low interest could shift costs to other payers or imperil small providers. The legislature’s action now moves the bill to the next steps for signature or enactment consistent with adopted effective dates.

The Senate adjourned following the vote and will reconvene on Monday, Feb. 9, 2026.