Rep. Andrew Engell tours hospitals in Okanogan and Chelan counties to learn more about challenges facing rural health care providers
CONTACT: Brendon Wold, Deputy Communications Director | 360-786-7698
Rep. Andrew Engell tours hospitals in Okanogan and Chelan counties to learn more about challenges facing rural health care providers
Rep. Andrew Engell traveled through Okanogan and Chelan counties last week to learn more about the health care challenges in the areas and seek solutions from the people on the ground. The 7th District freshman lawmaker met with leadership from Mid-Valley Hospital in Omak, North Valley Hospital in Tonasket, and Three Rivers Hospital in Brewster. He also joined Rep. Brian Burnett of the 12th District to visit Confluence Hospital in Wenatchee.
“What I consistently heard from hospital leadership is they are struggling under the weight of government regulations and inadequate payment for services from the government payers,” said Engell, R-Colville. “About 75 percent of patients using the hospitals are on Medicaid or Medicare, and both only pay a small portion of the bill – leaving the remaining 25 percent to patients and their insurance to make up the difference. This is driving up private insurance premiums and reducing access to health care as providers make decisions to reduce services to keep their doors open.”
Uncertainty at the federal level around potential cuts to Medicaid is also causing concerns for rural health care providers, as any reductions of payments will make it more difficult for providers to stay in business and serve their communities.
Engell emphasized that staffing continues to be a problem, which is exasperated by constantly changing state employment laws. There is also a statewide nursing shortage that affects the four hospitals he visited.
“In the midst of this nursing shortage, the Legislature has been mandating more nurses be hired. This is not working well when there aren’t any available to hire without creating shortages at other facilities,” said Engell. “There are people interested in becoming nurses, but the nursing programs aren’t able to train enough of them. In order to become a nursing instructor, the nurse is required to get a Master’s degree and then take a pay cut. Many don’t want to make that sacrifice. If we would allow experienced nurses to teach without a Master’s degree, it would be a step in the right direction.”
Engell also sees the bureaucracy taking its toll on rural hospitals.
“They are still required to report COVID cases every day, which causes a burden on their staff, and they don’t see any benefit from this requirement. The employees in charge of reporting are obligated to take a laptop home to submit their reports, even on their days off,” said Engell. “In an urban setting, there may be more than one person who can handle this mandate. But in a rural facility, it’s a real challenge.”
Engell is a member of the House Health Care and Wellness Committee, where he is working to learn, collaborate, and find solutions to the problems facing rural health care providers. In the 2025 legislative session, Engell’s first as a state lawmaker, there were several bills related to health care that either helped or hurt rural hospitals and health care providers.
“There was a bill to cap how much insurance companies that cover state employees have to pay to hospitals,” said Engell. “The bill passed, but we were able to get most of the small hospitals exempted – which helps.”
Engell also noted there were bills introduced this year designed to charge sales tax on wages to traveling doctors and nurses and on the electronic medical records system that hospitals are required to use.
“Paying more in sales tax on these things could be the last straw for some small hospitals,” said Engell. “Fortunately, we were able to get amendments adopted to protect hospitals from these bills. For now.”
The rural vs. urban divide was a common theme on Engell’s tour. North Valley Hospital CEO John McReynolds asked Engell to continually remind people in Olympia that small hospitals aren’t Harborview, which is a large hospital in Seattle.
“While small hospitals are grateful to be exempted from burdensome legislation, they are concerned with the impact to larger hospitals they rely on when their patients need a higher level of care. The large hospitals often struggle from many of these same issues and aren’t able to take patients from smaller hospitals, which isn’t good for anyone,” concluded Engell. “The state also made cuts to Medicaid, which will impact all health care in our state.”
The 105-day, 2025 legislative session ended on April 27. The 60-day, 2026 legislative session will begin on January 12.
