GOP Medicaid cuts to wallop Washington

Nearly 5% of the state's people projected to lose medical insurance

Editor’s note: Marissa Heffernan was a reporter at The Daily News in Longview from 2019 through 2021, covering education, courts and environmental issues. More recently, she was a writer for Resource Recycling, a Portland-based newsletter for the recycling industry.

By Marissa Heffernan

As many as 330,000 Washingtonians — about three times the entire population of Cowlitz County — will lose health care insurance under the Trump-backed budget bill Congress passed last week, according to at least one estimate.

By slashing Medicaid coverage for an estimated 12 million Americans, the bill will lead to medical staff layoffs, hospital closures and reduced employment in a major jobs sector of the state, medical providers and others say.

In Washington, nearly 5% of the state’s 8 million people —or about 400,000 inhabitants — will lose insurance, according to estimate from Newsweek. That’s even higher than NBC’s estimate of 330,000.

PeachHealth and Kaiser Permanente are the two largest healthcare providers in Southwest Washington. Neither would directly comment on the cuts’ impact to their operations.

PeaceHealth runs St. John Medical Center, a Catholic hospital in Longview, as well as a hospital and clinics in the Vancouver area. Kaiser owns two dozen facilities in the area, the majority in Longview. They are both major sources of employment in Southwest Washington.

PeaceHealth representatives pointed to a statement released July 3 by the Catholic Health Association of the United States, which said the bill will have “devastating consequences.”

Health Association President and CEO Mary Haddad said in the statement that the legislation will halt the progress hospitals have made in expanding access and improving health outcomes.

The effects “will be felt in every emergency room, clinic, and household struggling to access care in an already strained system."

“There’s no way we can absorb this level of cuts in the Medicaid program without massive impacts to all Washingtonians’ access to care.”

— Cassie Sauer, president and CEO of the Washington State Hospital Association

Overall, the bill will add more than $4 trillion to the national debt over the next decade, along with other changes and cuts to federally funded social programs.

“By sweeping away the social safety net that millions of vulnerable Americans rely on, Congress has prioritized the wealthy over the well-being of children, families, and those most at risk,” Haddad continued in the statement. “Health care is not a privilege — it is a fundamental expression of our shared commitment to human dignity and the common good.”

Local Kaiser representatives provided a companywide statement released July 4, which urged Congress and the administration “to consider action in the coming weeks to mitigate the loss of health coverage for so many people.”

The statement suggested that Congress renew the health care tax credits that are set to expire at the end of this year.

“Without the ability to pay, newly uninsured people will find themselves having to delay care leading to more serious and complex health conditions, increasing the use of emergency services and more intensive medical services,” the statement noted. “This will affect all of us as the cost of this uncompensated care leads hospitals and care providers to charge paying customers more to cover their costs.”

“Rural hospitals across Southwest Washington would lose tens of millions of dollars – which could put these vital lifelines at risk for collapse.”

— U.S. Rep. Marie Glusenkamp Perez

U.S. Rep. Marie Gluesenkamp Perez (WA-03) said the bill “undermines the economic power of hardworking Southwest Washington families and increases the red tape separating us from durable health — all to advance the short-term wealth of the well-to-do.”

In a July 1 statement, the Southwest Washington Congresswoman blasted the increase in the national debt, the “freebies” given to the wealthiest Americans and the healthcare cuts, calling the bill “a bloated product of single-party control and a concoction of special favors for special interests.”

She added: “Rural hospitals across Southwest Washington would lose tens of millions of dollars — which could put these vital lifelines at risk for collapse.”

Healthcare groups have also been warning of the consequences the bill. Cassie Sauer, the Washington State Hospital Association president and CEO, said in a statement that the budget bill passed by the Senate, and eventually adopted by the House, “is a disaster for Washington State’s hospitals and the patients we serve.”

Sauer warned that there’s “no way we can absorb this level of cuts in the Medicaid program without massive impacts to all Washingtonians’ access to care.”

That’s because as people lose Medicaid-based health insurance, hospitals will receive fewer payments, undermining their ability to function.

“Important hospital services will disappear, nurses and doctors will be laid off, and several Washington State hospitals are at risk of full closure,” especially smaller, rural hospitals, Sauer predicted.

Washington’s two U.S. senators — both Democrats — opposed the budget bill. But the senators from Idaho, Montana, Alaska and Wyoming — all Republicans — voted for the bill, and many people from those states “rely on Washington’s specialty care,” Sauer pointed out.

Politico noted that more Medicaid enrollees are voting Republican, and are therefore likely to feel the effects of the cuts. However, Republican leaders have argued that the changes will eliminate waste, fraud and abuse, leaving benefits intact for mandatory acute-care spending.

Republican Representative Buddy Carter from Georgia said during the July 3 floor debate of the bill that it “saves and sustains Medicaid and is there for those who truly need it.”

The bill requires Medicaid recipients to work, volunteer or be enrolled in school for at least 80 hours a month, in an effort to root out supposed freeloaders on the system.

However , a study by KFF, a San Francisco-based health policy think tank, debunked that notion. In 1993, KFF found, 92% of Medicaid recipients under 65 who weren't receiving disability benefits were working full- or part-time, were attending school or were providing caregiving obligations. The remaining 8% of adults on Medicaid reported that they were retired, unable to find work or were not working for another reason.

To help address concerns about the effect of the Medicaid cuts on rural hospitals, the Senate added a “rural health transformation fund” of $10 billion per fiscal year, but Sauer called the fund “wholly inadequate.”

“Offering this as a solution is like punching someone in the face and then offering them a Bandaid,” she said.