WASHINGTON, October 27, 2026 – The young man who overdosed on fentanyl at Harborview Medical Center had actually overdosed twice within the week. According to Dr. Lauren Whiteside, he got him into outpatient treatment and a month later was stabilized on medication. After six months, he had housing.
This, according to Dr. Whiteside, is what happens when people get access to care. This is precisely why Washington’s hospital executives are raising an alarm about the anticipated Medicaid cuts, which would result in stripping away almost $6 billion in income for the state’s hospitals up until 2033.
The projections are from a recent report that came out from Washington’s hospital and community health associations. All this happens as voting starts already before next month’s mid-term elections with Democrats focusing on health-care costs and loss of coverage while Republicans justify the Medicaid cuts as being inevitable in reducing the fraud and abuse.
The numbers behind the warning
The losses will not be incurred all at once. Hospitals forecast a loss of $339 million from revenue loss in 2027, which will increase yearly to about $1 billion a year by the 2030s.
Some 200,000 Washington residents are expected to become ineligible for Medicaid by the end of the year. About 600,000 enrollees will be subjected to work requirements starting January 1: they must show evidence of having worked, volunteered or taken classes for at least 80 hours per month every six months, or get a waiver. This will apply to healthy adults up to age 64 who don’t have dependents below the age of 13.
Those who are eligible for insurance are also at risk of losing their eligibility due to ongoing paperwork problems. Some 10,000 people were also disenrolled on October 1 after the law made those who are refugees, asylees, and other immigrants ineligible for Medicaid, including Ukrainians fleeing the war and human trafficking victims.
Why hospitals are worried
Here’s the problem: Hospitals are supposed to provide care for patients regardless of their ability to pay. Fewer people having Medicaid means more people will put off seeking care until they get into the emergency department.
“When you reduce the cost of uncompensated care, you reduce health care costs,” U.S. Sen. Maria Cantwell said during an Oct. 20 press conference at Harborview. “When you don’t do that, you are literally increasing the cost on all of us.”
But there could be more ramifications. The leaders at the hospital say that loss of revenue could mean job losses, closing of clinics, longer wait times in the ER and increased insurance costs for those who remain insured. Sommer Kleweno Walley, chief executive of Harborview, says reduced funding of safety net hospitals will hurt Medicaid and uninsured patients but also the hospital’s ability to serve the whole community.
Rural Washington feels it first
But the rural hospitals will be hit the hardest. The Congressional District #6 in Olympic Peninsula will have an estimated loss of about $1 billion, with Congressional Districts #2 and #5 in northwest and eastern parts of Washington State coming in a close second.
According to the chief executive of Jefferson Healthcare in Port Townsend, the hospital will see a loss of millions in revenue along with an estimated additional cost of more than $1 million for uncompensated care.
“Small rural hospitals will be harmed disproportionately,” Glenn said, “because rural communities tend to be older and poorer than urban communities, and more dependent on public payers like Medicare and Medicaid.”
Rural healthcare has also been granted $50 billion nationwide in the package from Congress. Washington is anticipating hundreds of millions in funding over five years; however, it is not known whether the funding will come quickly enough or whether there will be enough money to counterbalance the losses.
Clinics and ERs already feel pressure
Community health centers, which cater to low-income patients and do not reject the uninsured, are expecting losses of $98 million to $118 million in Medicaid payments. At least 82,000 patients are projected to lose their health insurance, resulting in more than 200,000 fewer annual patient visits.
“During one visit, I recall a patient who was waiting for a hospital bed when getting his medication by IV drip. He was out of his drip, and he went into shock; we got him into a room and saved him,” Dr. Marie Vrablik, emergency department medical director at UW Medical Center-Montlake Campus, said.
“However, because of crowding and people waiting for services that in a different scenario they would get in a primary care office, we could not admit him in a timely fashion,” she added. “As a physician, I am worried that we will be seeing more of these cases.”
At the moment, the forecasts are still estimates and not definitive results, but hospital administrators believe the trend is set.
