Providers, families warn elimination of adult OT/PT/SLP benefits in HB 22‑89 would shift costs and harm patients

A prolonged block of public testimony focused on a single, sharply contested proposal in the chair’s substitute for House Bill 22‑89: elimination of Medicaid coverage for adult occupational therapy (OT), physical therapy (PT) and speech‑language pathology (SLP).

Multiple clinicians, association leaders, service providers and family members described real‑world consequences they say will follow if the coverage is removed. Dr. Jamie Flick, an occupational therapist and educator, told the committee that skilled therapy is often the difference “between permanent disability and a loss of purpose and a return to work,” and cited a 23‑year‑old traumatic brain‑injury patient who regained independence through therapy. Kate White Tudor, representing the Washington Occupational Therapy Association, said the cut “saves $8 million to the state but eliminates $40 million in services,” and asked the Legislature to reverse the change.

Providers described how therapy reduces hospital readmissions, prevents avoidable institutionalization and supports community living. Deanna Winterrose said HCA claim data indicate the cut would affect about 93,000 clients and could result in roughly $32 million in lost federal matching dollars. Home‑health and skilled‑nursing administrators warned that shifting care to hospital or residential settings would increase long‑term state costs and reduce access to community‑based living.

Family members and advocates pressed a similar line: without therapy, adults with disabilities could lose mobility, communication devices and other supports that preserve independence. Multiple speakers said that eliminating therapy coverage will disproportionately hurt rural communities and people with long‑term disabilities.

The testimony included specific, repeated appeals to restore therapy coverage. Several providers suggested targeted alternatives—rate‑setting changes or narrowly drawn eligibility reforms—rather than a blanket elimination. Committee members did not take a vote during the public comment period; staff and advocates said they expect amendments and further negotiation in the coming days.

What happens next: The testimony creates a clear record of opposition from providers, family advocates and some local governments; the committee will consider amendments and negotiate with the Senate before any final funding decision is made.