Officials, caregivers and patients warn proposed Medicaid cuts would threaten Washington safety net

Harborview Medical Center leaders, Washington Gov. Bob Ferguson, labor representatives, caregivers and patient advocates held a press conference at Harborview on Monday to warn that congressional proposals to reduce federal Medicaid funding could imperil hospitals, nursing homes and essential services across the state.

"There is no more appropriate place than Harborview to highlight the critical role that Medicaid plays," said Summer Clavinowalley, chief executive officer of Harborview, describing the hospital as "the backbone of the state's health care safety net." Clavinowalley said more than 34 percent of Harborview patients rely on Medicaid and that the hospital provides care to thousands of patients from across Washington and neighboring states.

Gov. Bob Ferguson said Washington spends about $21,000,000,000 on Medicaid (Apple Health), with roughly $13,000,000,000 coming from the federal government. "We estimate that if adopted, at least 200,000 Washingtonians would lose their health care coverage by the end of next year," Ferguson said, and he said an initial state projection showed "about the loss of approximately $2,000,000,000 in federal funds over the next 4 years" if the congressional measure were enacted by the Senate.

Why it matters: Apple Health covers roughly 1 in 5 Washingtonians—about 2,000,000 people, including about 800,000 children—and is the largest payer for opioid use disorder treatment and long-term care in the state. Officials warned that steep reductions in federal matching funds would not only affect Medicaid beneficiaries but could destabilize hospital finances and force closures of services that serve the whole community.

Caregivers and patients at the event described the human impacts they fear. "Medicaid provides stable jobs and funding for services we deliver," said Martha, a home care aide with more than a decade of experience, describing clients who depend on Medicaid for therapy, equipment and in-home assistance. Sam, an RN at Harborview for 12 years, said unpaid or underfunded care stretches hospital resources and can lead to longer waits and worse outcomes for all patients.

Parent advocate Jen Chong Jewell said Medicaid and the Affordable Care Act helped her family pay for surgeries, therapies and assistive technology for her son. "Medicaid allows my son and so many other children and youth to live, be supported and thrive in their communities," she said, and urged constituents to "share your story" with members of Congress.

Local officials emphasized the scale of the effect. An unnamed mayor noted that Medicaid accounts for an estimated 73 percent of funding at the Seattle Indian Health Board and said about 450,000 King County patients could be affected. Ferguson warned that some rural and urban hospitals and nursing homes could close if funding fell sharply.

State response and next steps: Ferguson said the governor's office and its team are compiling impact data and would pursue every available option to persuade the U.S. Senate to reverse or mitigate the measure. "This is a 4 alarm fire," he said, urging residents to contact members of Congress; he added that the state's rainy day reserve fund "is not gonna be a safeguard" at the scale of the cuts under discussion.

Harborview officials said they would have to hold contingency discussions with their board and King County elected officials about which services could remain open if significant funding reductions occur. Clavinowalley offered to provide reporters a list of specific facilities or programs operating in the red after the press conference.

The press conference ended with officials inviting follow-up questions and saying they would continue outreach and advocacy in the coming days.