Proposed Medicaid cuts threaten rural healthcare in Washington, experts warn
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Proposed federal Medicaid cuts could have consequences for Washington state, hitting rural communities hard. More than 1.8 million residents in Washington rely on Medicaid for health care. A Republican-led plan in the U.S. House to slash $880 billion could lead to service reductions, higher costs and hospital closures.
According to Manuel Navarro, the CEO of Columbia Valley Community Health, approximately 46% of their patients are covered by Medicaid. The organization provides essential medical services to rural communities in Chelan and Douglas counties.
“Cutting Medicaid is a cost shift. The concept of saving money by cutting Medicaid is a fallacy, a cost shift. If you don’t take care of the patients in a rural health clinic or community health center or a physician’s office, those patients are going to have issues that require attention down the road,” Navarro said. “You are going to spend it down the road in higher cost care and you’re going to spend it in other areas in the economy. A healthy population is a good economy.”
Medicaid in Washington state, known as Apple Health, is a government program that provides free or low-cost health coverage to low-income individuals and families.
It is jointly funded by the federal and state governments and managed by the Washington State Health Care Authority. Medicaid covers a wide range of services including doctor visits, prescriptions and mental health care.
More than 800,000 adults in Washington are covered by Medicaid according to KFF, a nonprofit health research organization.
In fiscal year 2023, Washington state received $12.5 billion in federal Medicaid funding, which accounted for 57% of all federal funding to the state. That’s according to a report by U.S. Sen. Maria Cantwell’s office.
Financial and economic consequences of Medicaid cuts
If there are cuts in Medicaid, the state budget would need to make up for the gap. Washington state lawmakers are already trying to solve a projected $12 billion budget deficit for the next four years.
According to Andrew Jones, the CEO of Confluence Health, a medical provider in North Central Washington, Medicare accounts for nearly 68% of the organization’s budget. Jones warned that cuts to these programs could disproportionately affect rural hospitals, some of which are already struggling financially.
“Most hospitals in Washington don’t return a profit. Many have no margin at the end of the year,” Jones said.
For many hospitals, especially those in rural communities, Medicaid provides financial stability. Reducing this funding could lead to layoffs or service reductions. According to Jones, rural hospitals may not have the economic resilience to withstand such cuts, potentially leading to a domino effect of health care disruptions.
Rural areas also have fewer options for providers and services when compared to more urban places. If providers are unable to sustain services in rural areas, people may need to travel longer distances to access the care they need, according to Navarro.
“We have more Medicaid patients than urban communities. It’s hard to fathom what would happen in the state because hospitals are so fragile to begin with,” Jones said.
Cassie Sauer, the president and CEO of the Washington State Hospital Association, said that cuts to Medicaid threaten not only access to care for its recipients, but for the entire community.
“Hospitals will be forced to close services like maternity care, mental health services, and outpatient care,” Saur said in a press release. “These closures will affect everyone, not just Medicaid patients.”
The potential cuts to Medicaid could have far-reaching consequences that extend beyond health care systems and hospitals. According to Jones, Medicaid helps ensure that individuals receive the care they need when they need it, preventing the development of more serious health issues that would require costly interventions later on.
“There is somewhat of a stigma around Medicaid, but people with Medicaid or Apple Health are just your neighbors and relatives, your friends and their kids. It’s not some other group of people somewhere else. It is the people all around you. It’s everybody,” Jones said.
Reneé Diaz may be contacted at renee.diaz@wenatcheeworld.com. Collaborative reporting by The Wenatchee World, NWPB and WSU’s Murrow College of Communication Newsroom Fellowship.
