POTENTIAL CUTS TO MEDICAID COULD THREATEN HEALTH COVERAGE FOR 248,000 WASHINGTONIANS
Washingtonians are at risk of losing health insurance coverage after the United States House of Representatives passed an amended version of the budget reconciliation bill on May 22 that proposes $880 billion in cuts to Medicaid. If it passes out of Congress, work requirements could remove thousands of Washingtonians from the program, and restrictions could limit access to gender-affirming care and abortion. Manatt Health estimates that 248,000 people in Washington will lose coverage, including 14,000 children.
Medicaid enrollees like Ari worry that they may lose access to vital care if the program is cut. Ari grew up in a family that wasn’t used to having access to health care, so even though she has been enrolled in Medicaid her entire life, she rarely saw a doctor growing up in Spokane, Washington.
“That’s what not having access to health care does to people. Sometimes even when they have it, they are too scared to use it.”
Once she was able to make her own health care decisions, she began accessing services and has since been diagnosed with several disabilities and neurodivergencies. Ari now has reliable access to doctors and most services and uses her coverage for everything from urgent care visits for her daughter to mental health services and antibiotics.
“When [my daughter’s] fever is too high and I Google it and it says to take her to the ER, I can take her to the ER. If we did not have access to health care, I would be more cautious in when I can do things like that.”
While it has been difficult for Ari to find therapy providers that take Medicaid, she weighs this barrier against the barrier of cost.
“Mental health care has been harder because a lot of the more private practices only take private insurance…If you have that added layer of cost on top of it, you’re going to drop out way sooner than sticking through it to see the benefits…Some things are a long haul.”
Because of her disabilities, Ari does not work full time and cannot afford to pay out of pocket for medical expenses. She attributes her ability to give birth to her daughter to Medicaid.
“I was able to go through with my pregnancy because I didn’t have to pay tens of thousands of dollars.”
Nearly half of births in Washington are covered by Medicaid.
Ari hopes others know that no one should be ashamed to be enrolled in Medicaid and rejects the narrative that people abuse the system. The data also rejects this narrative. Indeed, 95% of Washingtonians enrolled in Medicaid are either working or cannot work.
“There’s nothing to be ashamed of. I think that it’s the kind of health insurance that everyone deserves. People should not have to panic about financial disaster when their life is already getting severely impacted by some sort of health emergency.”
If Congress cuts Medicaid, Ari is concerned that rural hospitals will be hit hardest, and that ultimately, everyone will be affected. One in six Medicaid enrollees in Washington live in rural areas, and 69% of Medicaid spending in Washington is federally funded.
“A lot of people in rural communities are on Medicaid, and these hospitals, they rely on the money coming in from federal funding from Medicaid. A lot of these places would close and there would be an overwhelm on emergency rooms everywhere if these things go forward. Every time they cut health care insurance these things happen. It gets harder and harder to see a doctor no matter how good your private insurance is. This affects everyone.”
Hospitals in rural Washington often receive over a quarter of their revenue from Medicaid, with some like Othello Community Hospital receiving 58% of their funds from Medicaid. To threaten these revenue sources would jeopardize access to care for residents of rural Washington across the state. This is especially harmful at a time when some clinics and hospitals are already struggling to stay open.
Ari is also concerned that transgender Americans on Medicaid are at risk of losing all access to transitional therapy, and that Washington state would have to choose to foot the bill or cut services.
“These Medicaid cuts will hurt everyone, and the trans community, which has been very targeted as of late, will suffer the most.”
Washington is one of 40 states to adopt Medicaid expansions, funding for which is threatened by the congressional budget bill. Medicaid expansions have been critical for reducing under- or uninsurance rates among LGBTQ+ youth and adults. In states without Medicaid expansions, 19% of transgender adults are uninsured, compared to 8% in states with expansions. Cuts to expansion funding would leave many LGBTQ+ Washingtonians without coverage and harm the transgender community in particular.
Protecting health coverage is also critically important for transgender youth in Washington. Having a trusted provider to turn to in times of crisis is essential for health and safety. In the 2023 Healthy Youth Survey, 44.9% of transgender 10th graders reported seriously considering suicide in the past year, and 1 in 4 felt they had no adult to turn to. Having a trusted adult to turn to has been shown to reduce suicide attempts among trans youth and recent surveys show that just over half of parents would be comfortable with their child coming out as transgender. This is why access to trusted health care providers is so important for LGBTQ youth, and trans youth in particular.
Expansions also helped uninsured rates drop dramatically across many communities of color. The most significant drop was among Indigenous and Hispanic communities, improving by 11.7 and 12.1 percentage points, respectively. There is no question that a rollback of expansion funding would see a rise in uninsurance among communities of color, only exacerbating already disparate health outcomes.
On June 16, the Senate Finance committee released its version of the reconcilliation bill and is expected to act in the coming weeks. Ari encourages Washingtonians to stay informed and contact their senators.
“Medicaid is under attack right now…If that infuriates you, call your senators and urge people to change their minds about this because it would not be good for anyone.”
If you are currently enrolled in Medicaid and would like to share your story with Children’s Alliance, fill out our story collection form or email becca@childrensalliance.org.