Threat to Medicaid raises concerns

The local impact of a Republican-led proposal to potentially cut Medicaid remains unclear, as some of Clark County’s largest health care providers are still unsure of the long-term consequences.

A budget resolution passed Feb. 25 by the Republican-controlled U.S. House calls for a potential $880 billion reduction in federal spending by the Energy and Commerce Committee, which oversees Medicaid, over the next decade.

Health officials say that will likely impact the country’s most vulnerable.

Medicaid was created in 1965 along with Medicare, the public health insurance program for Americans 65 and older. Medicaid supports health care access for low-income adults and children, including more than 1 in 3 people with disabilities.

Though Medicare and Medicaid started as basic insurance programs, both programs have changed over the years to offer care to a diverse range of groups, including low-income families, pregnant women, people of all ages with disabilities and people who need long-term care, according to the Centers for Medicare and Medicaid Services.

The impact on patient access at PeaceHealth Southwest Medical Center and Legacy Health Salmon Creek Medical Center remains uncertain.

PeaceHealth spokeswoman Debra Carnes would not comment on the implications cuts would have for Clark County patients who receive Medicaid. Legacy Health spokeswoman Vicki Guinn said it is too soon for the hospital to know.

Vancouver Clinic — an independent, physician-owned practice serving Southwest Washington and Oregon — said it is deeply concerned over any federal cuts to the Medicaid program.

“Physician groups nationwide are closely monitoring the situation. It’s too early to speculate on potential impacts except to say cuts in Medicaid would lead to challenges in maintaining the same level of care and access for our patients,” Vancouver Clinic spokeswoman Kelly Love wrote in an email Tuesday. “We remain committed to providing excellent, high-quality care to our communities.”

Kaiser Permanente echoed that statement and urged policymakers to consider the importance of Medicaid for millions of Americans.

“Medicaid gives millions of Americans access to the front door of the health care system. It helps keep them healthy and provides for those with acute and chronic care needs. And it is critical to the stability of providers and hospitals — especially rural hospitals,” Kaiser spokeswoman Karen Vitt wrote in an email Wednesday. “We urge policymakers to take a judicious approach to prevent changes that would harm the health of millions and undermine our health care system.”

Cantwell: Funding is crucial

In a snapshot report released Feb. 25 by U.S. Sen. Maria Cantwell, D-Wash., health advocates, hospital staff and medical directors all weighed in on what a budget cut of this size would do to Washington’s health care system.

According to the report, these cuts would be devastating for the more than 1.8 million Washingtonians who are enrolled in Medicaid, including children, seniors and low-income residents.

“The magnitude of the proposed cuts would not spare anyone in our state — not hospital staff, not people with coverage through their employer, and especially not our state’s children, 47 percent of whom are covered by Apple Health, Washington State’s Medicaid program,” Cantwell said in her report.

In 2023, Washington received more than $12.5 billion in federal Medicaid funding, which accounted for 57 percent of all federal funding statewide, the report found.

Because hospitals already function on extremely thin operating margins, Medicaid is a crucial source of revenue to sustain daily operations, Cantwell said.

Any cuts in federal Medicaid funding would not only reduce the number of people enrolled; it could also worsen Washington’s projected budget deficit of more than $12 billion over the next four years, because the state would need to make up for the loss of those health care services, according to the report.

“Medicaid patients will not stop needing care. Hospitals will still need to treat these patients — they will just receive less money for it,” Cantwell said. “They’ll have to make up the difference somehow. That’s why hospital leaders say that cuts to Medicaid will likely result in cuts felt by every patient.”

According to the Washington State Hospital Association, Medicaid funded 23 percent of inpatient care and 19 percent of outpatient care for Washington’s hospitals in 2023.

Cantwell’s report also outlined data on the percentage of Medicaid patients in each of Washington’s congressional districts, including by region. In the 3rd Congressional District, which includes Clark County, 50 percent of children 19 and younger and 17 percent of adults are covered by Medicaid.

“Cuts to Medicaid don’t just threaten access to care for Medicaid patients. The level of Medicaid cuts being contemplated at the federal level are enormous. These funding cuts will lead to hospitals closing services, and those services will be lost for the whole community,” Washington State Hospital Association CEO Cassie Sauer said. “We have already seen closures of maternity services, mental health services and outpatient services such as physical therapy that have affected entire communities. These will only grow.”

Closures possible

Rural hospitals would also take a hit as farm families would potentially have to travel more than 100 miles round trip for routine or emergency care, the report said.

“Multiple rural hospitals report that Medicaid cuts would endanger their financial stability and even put them at risk of closure,” Cantwell said. “That threatens access to health care for entire rural communities — not just Medicaid patients.”

Outside of hospitals, community providers and nurses said in the report that if people lost access to Medicaid, they might forgo or delay care altogether, which could damage access to care for entire communities.

The budget resolution will now be considered in the U.S. Senate. Eventually, the House and Senate will have to adopt the same budget plan and vote on a final package.

“As families struggle with their ability to afford quality health care, Medicare funding reductions could mean longer wait times at the emergency room, slower response times for emergency vehicles or even the closure of local hospitals,” Cantwell said.

Chrissy Booker: 360-735-4613; [email protected]

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