Washington state leaders are sounding the alarm over a Republican-backed budget bill that recently passed in the U.S. House, which could potentially strip 194,000 residents of their Medicaid coverage.
According to estimates from the Democrats on Congress’ Joint Economic Committee, only eight states could see a higher loss of Medicaid beneficiaries than Washington.
Additionally, the bill threatens to cut approximately $2 billion in federal Medicaid funding to the state over the next four years, which Governor Bob Ferguson addressed during a press conference at Harborview Medical Center in Seattle.
Ferguson emphasized that there is no financial reserve to compensate for these impending losses, stating bluntly, “no rainy-day reserve fund is going to backfill that.”
Despite the looming cuts, he refrained from declaring that a special legislative session would be necessary, as many provisions of the bill won’t take effect immediately.
Officials have expressed concerns that these cuts could devastate the state’s nursing homes and rural hospitals.
“Hospitals will close in Washington state, in rural parts of our state and urban parts of our state,” Ferguson warned. “Take that to the bank. That’s going to happen. Nursing homes in our state will close.”
In response to the potential cuts, around two dozen Republican lawmakers from Washington, led by House Minority Leader Drew Stokesbary, have appealed to their state congressional delegation, urging them to protect the Medicaid program known as Apple Health.
In their letter, they expressed, “We urge you to protect Medicaid. We can’t afford to lose local health care resources, and our rural communities will not be able to ride out the economic shockwaves that are sure to follow if this program is significantly cut.”
This letter represents a notable shift from Republican lawmakers’ generally muted stance on federal policies regarding Medicaid cuts since the administration of President Donald Trump began in January 2017.
On Thursday, U.S. Rep. Michael Baumgartner from Spokane, who previously served in the Washington state Senate, voiced his support for the House bill while criticizing state leadership in Olympia through a series of social media posts.
He remarked, “Elections have consequences and the contrast between leadership in Washington DC and Washington state is stark,” and also took aim at Ferguson for signing state laws increasing taxes.
Baumgartner’s sentiments reflect a growing divide between state officials and Congressional Republicans regarding the implications of the health care legislation.
The House bill, which narrowly passed with only Republican votes, encompasses a range of changes beyond Medicaid funding cuts, including extensions of tax cuts enacted during Trump’s first term, increased border security funding, modifications to energy project permitting, and a restructure of college aid systems.
House Republicans have outlined plans to implement reductions of between $600 billion and $700 billion to Medicaid over ten years — a program that provides health care for lower-income or disabled individuals and covers nearly a quarter of Washington’s residents.
Despite the backlash from various parties, Congressman Dan Newhouse from Sunnyside defended his vote, calling the legislation a means to introduce “real, common-sense reforms to strengthen the integrity of Medicaid, protecting the program for low-income families, seniors, and those with disabilities.”
A significant aspect of the proposed legislation is the requirement for certain Medicaid recipients to prove their employment status in order to maintain coverage.
Under the bill, childless adults without disabilities would need to work, volunteer, or attend school for 80 hours each month, with certain exceptions.
This requirement would take effect by the end of 2026, a shift from the previously intended implementation in 2029, which was meant to provide states more time to comply.
Current data reveals that 70% of Washington adults enrolled in Medicaid are already employed, according to the Kaiser Family Foundation (KFF).
Democrats have strongly denounced the legislation, framing it as a maneuver to finance tax cuts benefitting wealthy taxpayers at the expense of lower-income families relying on safety-net programs.
Rep. Suzan DelBene remarked, “This legislation is a betrayal of Republicans’ promise to lower costs for everyday families. It will rip health coverage away from millions of families while increasing groceries, utilities, and health care bills.”
Moreover, the bill poses a risk to states like Washington that offer Medicaid-style coverage to immigrants lacking legal status.
Washington’s program for immigrants is currently limited and funded entirely through state resources.
House Republicans propose to decrease the federal contributions for Medicaid enrollees under expanded eligibility from the Affordable Care Act, which could shift $10 billion in costs to Washington over the next decade, per KFF analysis.
By the latest counts, nearly 2 million residents in Washington are enrolled in Apple Health, among them over 850,000 children, as reported by the state Health Care Authority.
Jen Chong Jewell’s 14-year-old son, Gabriel, who has developmental disabilities, relies on Medicaid for surgeries and therapies.
“I love my son, and I hate that he, along with so many others, are being swept into this narrative about the need to, quote ‘eliminate waste, fraud, and abuse,’” Chong Jewell expressed, voicing concern over the stigmatization of vulnerable populations.
Further complicating matters is the anticipated expiration of expanded tax credits linked to the Affordable Care Act, which may result in another 79,000 residents in Washington losing their health coverage, according to congressional assessments.
Altogether, nationwide estimates suggest that the legislation could lead to 13.7 million people losing their coverage by 2034.
The bill additionally proposes to halt coverage for gender-affirming care for transgender individuals and reproductive care services provided through Planned Parenthood.
State Senate Majority Leader Jamie Pedersen was among over 500 legislators nationwide who reached out to congressional leaders this week, advocating for the preservation of Medicaid funding for Planned Parenthood services.
Finally, a reduction in federal food stamp benefits (SNAP) could also impose an additional $300 million in annual costs that would need to be absorbed by Washington, according to Governor Ferguson’s office.
As the situation develops, both sides of the political spectrum continue to grapple with the implications of the proposed changes while residents and healthcare providers brace for the possible repercussions of the sweeping cuts.
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