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Washington hospitals forecast $5.8 billion in losses from Medicaid cuts by 2033
A report from Sen. Maria Cantwell’s office projects $5.8 billion in losses for Washington hospitals by 2033 as federal Medicaid cuts take effect. Health leaders warn the funding squeeze could mean fewer services, longer waits and greater pressure on rural hospitals and community clinics.
Washington hospitals could lose $5.8 billion in revenue by 2033 under federal Medicaid cuts, according to projections released Tuesday by Sen. Maria Cantwell’s office. Community health centers could lose as much as $118 million by the end of 2027, the report says.
The estimates, compiled by the Washington State Hospital Association and the Washington Association for Community Health, point to rising costs for care that hospitals provide but Medicaid does not reimburse. Hospital leaders warn that mounting uncompensated care could force service reductions and make it harder for patients to get timely care.
At a news conference at Harborview Medical Center in Seattle, Cantwell, a Democrat, called for the cuts in House Resolution 1 to be reversed or rolled back. “This is a price we’re all going to pay because of ballooning access to care,” she said. “When hospitals are left to absorb these losses, they have to make difficult decisions.”
The law’s Medicaid changes are already affecting coverage. Beginning in October, about 11,000 lawful immigrants in Washington lost Apple Health coverage after eligibility rules changed. New work requirements are scheduled to take effect Jan. 1. The state initially projected the requirements could disrupt coverage for about 600,000 residents during 2027, but has since lowered that estimate to about 200,000, citing an online verification system intended to help people identify exemptions and retain coverage.
Nearly 2 million lower-income Washington residents are enrolled in Apple Health, which is funded jointly by the state and federal governments. As people lose coverage or face higher out-of-pocket costs, they may delay appointments and prescriptions, Harborview CEO Sommer Kleweno Walley said. That can allow health problems to worsen and lead to more expensive emergency care, she said.
Harborview expects to provide at least $20 million in care Medicaid will not reimburse in 2026, Kleweno Walley said. The hospital plans to continue treating patients regardless of ability to pay, but expects to rely more heavily on its state charity care fund. She warned that financial strain could threaten services beyond those used directly by people losing Medicaid.
Rural hospitals may face especially steep challenges. Jefferson Healthcare, a 25-bed hospital in Port Townsend, is preparing for revenue losses of $6 million to $8 million, CEO Mike Glenn said. Rural communities tend to have older, poorer populations and greater reliance on public insurance programs, he said, leaving their hospitals disproportionately exposed.
Community clinics are also preparing for coverage losses. HealthPoint, a King County health center, said about 1,600 of its patients were set to lose Apple Health coverage in October. CEO Lisa Yohalem said as many as 10,000 HealthPoint patients could lose coverage next year. “For patients, the consequences can be immediate,” she said.