What $1 Trillion in Medicaid Cuts Means for Washington Physicians and Patients
By Nancy L. Belcher, PhD, MPA | CEO, KCMS
Congress passed the largest federal healthcare cuts in U.S. history—nearly $1 trillion over the next decade, much of it targeting Medicaid. These changes are being called the most significant shift in healthcare policy since the Affordable Care Act. For physicians, health systems, and public health advocates in WA State, these changes demand urgent attention.
Medicaid: The Safety Net for 1 in 4 Americans
Medicaid is often seen as a program for the very poor, but its reach goes beyond that; it:
- Covers 42% of all US births
- Funds long-term care for millions of seniors
- Provides for children with special needs, chronically ill adults, and people with disabilities
- Keeps rural and safety-net hospitals financially afloat
In WA State, more than 2.1M residents - over 1 in 4 people - rely on Medicaid for health coverage.
What’s Changing?
These cuts were not passed through the usual budget process, but through reconciliation—a fast-track legislative tool that allows budget-related legislation, including nearly $1 trillion in Medicaid cuts, to pass with fewer votes. While the Medicaid cuts don’t eliminate the program outright, they make it harder to stay enrolled and reduce federal support for states. Key provisions include:
- New work requirements for eligibility, even though most Medicaid recipients work or can’t work due to disability or caregiving
- Mandate frequent eligibility verification, increasing paperwork and coverage gaps
- Cut federal matching funds—hitting Medicaid expansion states like WA hardest
- Limits on how states can generate or supplement matching funds
Why This Matters for Washington State
Washington's health system is built on partnerships between state investment and federal support, and these cuts threaten to destabilize that balance. The impact will fall hardest on our vulnerable patients and ripple through clinics and hospitals, especially in areas like:
- Safety-net and community health centers
- Critical Access and rural hospitals
- Physicians in primary care, geriatrics, pediatrics, and behavioral health
This Quiet Bureaucratic Shift Is Setting the Stage
The impact is real and measurable. An estimated 11 million Americans are expected to lose coverage over the next several years, and hundreds of hospitals, particularly in rural and underserved areas, are at risk of closure. Washington physicians will likely see:
- More uninsured patients in our EDs and community clinics
- Nursing home closures as Medicaid funding dries up
- Hospital cutbacks and staff reductions, especially in already-stretched rural areas
- Rising medical debt and delayed care for conditions that should be preventable
- Greater strain on an already stretched system
- A wider health equity gap, with underserved communities facing greater barriers
So What Can You Do?
The changes are phased in gradually, with much of the impact delayed until 2026–2028. That gives us some time. But only if we act now. Here’s what we can do:
- Use our voice to explain the real impact of these policies and the lived experiences of patients.
- Educate patients—especially those relying on Medicaid—about new requirements and renewal timeline.
- Join KCMS (or renew) to strengthen organized medicines' response and advocacy. Join or renew HERE.
- Engage with the KCMS Delegate Council and help shape policy that defends your profession. Write or co-author a resolution, or lend your name and support to one of ours, info@kcmsociety.org
- Advocate for Medicaid: Advocate for transparency in how WA state will implement these changes. Whether it’s writing op-eds, testifying, or briefing lawmakers, KCMS will support you to share your perspective.
- Stay connected and 'like' KCMS's social media platforms and activate your network. Use your platform—social media, peer conversations, rounds—to ensure other doctors understand what’s coming and how to speak up.
👉 Follow us:Facebook | X (Twitter) | Instagram | LinkedIn 👉
🎓 Support the Next Generation of Physicians
Make a lasting impact by donating to the KCMS Community Foundation grant fund, a 501(c)(3) charitable organization. Your gift is tax-deductible and helps build a resilient, well-trained healthcare workforce.
KCMS Community Foundation grant fund.
Bottom Line - We Are Stronger Together
These policy shifts may feel overwhelming, but KCMS is your professional home. Together, through collective action and organized advocacy, we can fight for a healthcare system that protects patients and supports those who care for them.
