By Jake Goldstein-Street - Washington State Standard. October 20, 2026
Washington’s hospitals anticipate losing nearly $6 billion in revenue through 2033 due to steep Medicaid cuts in the coming months.
That’s according to a new report from the state hospital and community health associations. It comes as Democrats play up high healthcare costs and coverage losses in the runup to next month’s midterm elections. Voting has already begun.
Democratic U.S. Sen. Maria Cantwell and local healthcare leaders discussed the expected woes for hospitals in a Tuesday news conference at Harborview Medical Center in Seattle. They emphasized that the hefty drop in federal funding for the insurance program serving low-income Americans from the tax break and spending cut bill congressional Republicans approved last year will affect all patients, as wait times in emergency rooms rise and premiums for those still insured increase to account for the lost revenue. Staff could be cut and clinics face closure.
Fewer people enrolled in Medicaid means more people going to ERs for care instead of being able to access primary care, and more costs that hospitals have to cover without being reimbursed, advocates say. Hospitals are required to serve patients in emergency departments whether they’ll be paid or not.
Around 200,000 Washingtonians are expected to lose coverage by the end of next year due to the cuts. Many could meet newly enacted work requirements but won’t be able to surpass constant new paperwork barriers to maintain their insurance, officials expect. About 600,000 enrollees are expected to be subject to these requirements.
The work requirements, which begin Jan. 1, will require enrollees to prove every six months that they’re working, volunteering or attending classes at least 80 hours per month or show they qualify for an exemption. The mandate would apply to healthy adults up to age 64 without dependent children under 13 years old.
Roughly 10,000 in Washington have already lost coverage on Oct. 1, as the law stripped Medicaid coverage for refugees, asylees and other lawfully present immigrants, including people who fled the war in Ukraine and trafficking victims, for example.
Tens of thousands of people have also dropped the health plans they had through the Affordable Care Act when insurance became less affordable as federal subsidies expired. The debate over this issue in Congress led to a lengthy federal government shutdown last year. Coverage through the state’s exchange will cost an average of 22.2% more in 2027.
Medicaid cuts will hit hospitals hardest in some of Washington’s more rural areas, like in the 6th Congressional District on the Olympic Peninsula, projected to lose $1 billion. The 2nd Congressional District in northwest Washington and the 5th Congressional District in eastern Washington are next on the list.
Meanwhile, clinics across Washington that primarily serve low-income patients anticipate losing between $98 million and $118 million in Medicaid reimbursements next year, according to the report. These federally qualified health centers serve as the safety net in many communities since they don’t turn away residents without insurance. The clinics estimate at least 82,000 of their patients across the state will lose health coverage, leading to over 200,000 fewer visits per year.