💉 Checking the Pulse 07/22/26

Larsen on hospital regulation: In the nation's capital, Republican legislators are shepherding a bill purportedly aimed at elevating the transparency of nonprofit hospitals.

The so-called Tax Exempt Hospital Transparency Act, or H.R.9504, would require tax-exempt hospitals like PeaceHealth to provide more insight about their use of taxpayer benefits. The legislation remains mostly partisan, with Republicans in support and Democrats opposing, so I was curious what our representative, Rick Larsen — who, you guessed it, is up for reelection again — thinks.

He opposes the bill.

Larsen’s opposition to the bill puts him in line with most Democrats… and none other than the American Hospital Association, which represents most hospitals, and therefore doesn’t want its members forced to disclose more information in tax filings.

I recently spent time digging through PeaceHealth’s tax returns. You can read that story here. As a system of nine hospitals, PeaceHealth, as a tax-exempt nonprofit, only has to file returns as a system, not for each hospital. The bill would change that, adding a requirement that paperwork be filed for each facility.

In a written statement to CDN, Larsen said:

“Republicans have sent healthcare costs skyrocketing and ripped health insurance away from tens of thousands of people in Northwest Washington. The Tax-Exempt Hospital Transparency Act creates burdensome paperwork requirements for academic health systems like the University of Washington Medicine and does nothing to lower costs for patients. I support efforts to increase transparency in hospital pricing, but this legislation would only make matters worse.”

I’d like to draw your attention to another IRS requirement for nonprofit hospitals. Per the IRS, nonprofit hospitals must maintain “a board of directors drawn from the community.” On July 1, PeaceHealth announced its newest system-level board member, touting his accounting experience. The new board member resides in the Milwaukee, Wisconsin area.

A few weeks ago, I reported that Whatcom County was losing one of its two part-time health officers with the departure of Dr. Meghan Lelonek, who served alongside Dr. Amy Harley. Now, the county says it doesn’t plan to fill the now-vacant position due to its budget challenges.

The budget is still in draft form, so the decision is temporary until a final 2027 budget is approved in the fall. So, for now, the county will have one health officer occupying the position as a 0.6 FTE. In not replacing Dr. Lelonek, a pattern is emerging at the county and the health department, which is nearly 10 months into Champ Thomaskutty's tenure: Vacated roles are going unfilled in the name of a difficult budget.

The federally qualified health center recently published a report reflecting on 2025, the year in which it began using a new electronic health record, a high logistical and financial hurdle for many healthcare organizations. During the last full year of outgoing CEO Jodi Joyce’s tenure, the healthcare provider’s revenues topped expenses by $1.9 million.

Unity Care NW served nearly 24,000 patients in 2025, more than half of whom were Medicaid patients and 700+ were migrant and seasonal agriculture workers. You can read the report here, but I’d like to draw your attention to something else the group has announced.

During 2025, Unity Care NW said it saw a “measurable” decline in patients best served in languages other than English during a time when federal immigration action was dominating national news and appearing locally, too.

Now, Unity Care NW says that in September, about 2,700 of its patients will receive letters reminding them the federal government will require proof of 80 hours a month of work or volunteering to retain Medicaid eligibility. This is, of course, a result of President Donald Trump and his Republican counterparts in Congress who passed legislation last year with cascading healthcare impacts still yet to be fully realized.

You may have heard about the Trump administration’s recent subpoenas of multiple New York Times reporters following their story on Trump's Qatar-donated Air Force One plane — reporting that was attributed to anonymous sources in the government. Earlier this week, we learned the federal administration sought phone records from the reporters, two of their spouses, and one’s mother, all in an attempt — as Trump's appointees put it — to weed out the journalists’ sources in the government (or, as federal employees are viewed by their bosses: leakers).

OK, and? Why are you reading about this in a local healthcare newsletter?

I often source my reporting to individuals in our community who request anonymity for various reasons. I don't deliberately seek anonymous sources, but I also don't deter requests for anonymity. Journalists nearly always prefer named, on-the-record sources, but that's because it's our job to ask people for information and report it to you; it’s not people's jobs to talk to us — mostly.

Many of the anonymous sources who speak with me are healthcare providers who request anonymity out of fear of retaliation. That line — "out of fear of retaliation" — is a very present reality for many first responders that should not be glazed over, discarded or scoffed at.

In some instances, I hear from sources at organizations I'm reporting on that during the weeks of reporting leading up to the publication of a story, members of leadership approach clinicians in the relevant department or organization to remind them of the company's prohibition on speaking with the press. Other times, after a story is published, executives or members of leadership approach clinicians on the relevant team that was the story’s focus to ask providers how they're doing, and in other instances, remind them of the organization’s media policies.

Writing in The New Yorker recently, courts and justice writer Ruth Marcus put it well: "Journalists’ access to information will evaporate if they cannot assure their sources of confidentiality."

Two weeks ago, a poll in this newsletter asked you: The last time you sought a new primary care provider in Whatcom or Skagit County, how long was your wait to get in with that new provider? Here are the results:

Under 2 months: 39%
2-6 months: 35%
6-12 months: 22%
Over a year: 4%

ProPublica: The Washington Medical Commission admitted it has failed to uphold its responsibility of timely alerting the public to wrongdoings of doctors, thanks to investigative reporting by the nonprofit newsroom and KUOW.

New Yorker Radio Hour (audio): Dr. Atul Gawande, a surgeon, writer and former assistant administrator for global health at U.S.A.I.D explains how an estimated 700,000 people have died from the Trump administration’s DOGE cuts.

KFF Health News: A brave and troubling first-hand account of needing and searching for a psychiatric bed.

The Guardian: Remember when Meta and Google were on trial in Los Angeles earlier this year for a landmark case regarding social media addiction and mental health? The lawyer who successfully exposed the giants tactically used a unique approach to win, making this profile of this Baptist preacher a must-read, especially given who he may face in court next.