Washington health officials warn HR 1 will shrink coverage, cut provider funding and raise verification burdens

Caitlin Stafford, the governor’s senior health policy advisor, and Washington State Health Care Authority officials told the Senate Health and Long Term Care Committee on July 22 that the federal budget and rule changes in HR 1 will likely cause immediate disruptions for the individual insurance market and substantial Medicaid funding and administrative changes over the next several years.

Why it matters: Committee members were told the combination of HR 1 provisions and potential expiration of enhanced premium tax credits could leave tens of thousands uninsured in January and reduce federal Medicaid dollars to the state by billions over a 10‑year window, forcing difficult budget and program choices for providers and counties.

State officials said HR 1’s provisions will produce losses in the individual marketplace beginning in January and that Medicaid impacts will follow. Caitlin Stafford said, “we're probably gonna start seeing at a minimum about 80,000 people not being able to afford coverage starting in January.” Dr. Sherissa Fotinos, Medicaid and behavioral health medical director at the Health Care Authority, summarized the wider effects: HR 1 shortens retroactive coverage, increases the frequency of eligibility checks, adds work and community‑engagement requirements for certain adults, restricts who can bill for some reproductive services, and caps state‑directed payments tied to Medicaid rates.

Officials…