By Carolyn Bick
NORTHWEST ASIAN WEEKLY
Overnight, the United States House of Representatives voted to make deep cuts to Medicaid, the federal program that provides medical insurance for low-income individuals, many rural and immigrant communities, and people who have lost their jobs.
The cuts are part of a bill that involves massive tax cuts for the wealthiest Americans. In order to offset the cost of these tax cuts, Congress has moved, at the behest of President Donald Trump, to cut hundreds of billions of dollars in Medicaid funding—which would mean cutting off 7.6 million Americans from healthcare access.
The bill’s $700 billion in total Medicaid cuts translate into the loss of $2 billion in Medicaid funding for Washington state over the next four years, Gov. Bob Ferguson said in a May 22 press conference. Washington currently spends $21 billion on Medicaid per year, $13 billion of which comes from the federal government.
One such Washingtonian who could lose his health coverage is Jen Chong Jewell’s disabled son, Gabriel. With Gabriel at her side, Chong Jewell laid out the situation facing not only her family, but thousands of families across the state and the nation.
Gabriel is one of the 800,000 children and young people whom Medicaid and connected services support in Washington state, Chong Jewell said. Even beyond healthcare, she said, Medicaid helped her family through its most challenging times, covering the cost of surgeries, therapies, medical equipment, and access to assistive technology. It even provided access to personal care hours.
Chong Jewell herself has been a beneficiary of Medicaid, when she was supported by President Barack Obama’s Affordable Care Act. She worked part-time, and her job did not cover her health care. Those years were financially tight and frightening, she said.
“I remember being scared that I would lose my job when I needed to take time off because he was sick or had appointments,” Chong Jewell said. “I recall times when we sold our belongings for extra cash, because the cost of childcare was outrageous. I have memories of visiting food banks and how alone I felt. At times, I felt so hopeless as a mother because I felt like I was failing him.”
Medicaid, alongside the Affordable Care Act, which expanded Medicaid coverage, helps to fund healthcare across the board in Washington state. For instance, Harborview Medical Center CEO Sommer Kleweno Walley said, Medicaid and the Affordable Care Act provide hundreds of thousands of dollars in coverage for Harborview alone. They also cover about $830 million in uncompensated and undercompensated care that the University of Washington’s hospitals provide to Medicaid, Medicare, and un-and underinsured patients, in addition to more than 68% of the state’s medical education and training.
Apple Health, Washington’s Medicaid program, covers about two million people, Ferguson said. More than 105,000 of those rely on Medicaid for long-term care, and more than 70% of the state’s rural births are covered by Medicaid.
If the bill passses as it is, Ferguson warned, it’s estimated that at least 200,000 Washingtonians will lose health coverage by next year. There is not enough in the state’s Rainy Day Fund, he said, to cover the loss.
Chong Jewell pushed back against the federal narrative that these cuts are being made to allegedly eliminate waste, fraud, and abuse within the system. She said that these cuts are being made in a way that ignores the real, lived experiences of those who rely on Medicaid.
“The current administrative burden on disabled individuals, families, and caregivers to access any kind of public health benefit and maintain eligibility is immense,” Chong Jewsell said.
It’s not just individuals who stand to lose, if Congress guts Medicaid. It will mean the closure of entire hospitals and rural care systems, leaving many Americans without access to emergency or even routine medical care.
A registered nurse at Harborview Medical Center and SEIU 1199 Healthcare Northwest union member who identified herself only as “Sam”, said that, currently, the hospital can provide healthcare to anyone, regardless of whether they have insurance. This is only possible, because of Medicaid—but even so, “it stretches our resources thin.”
Sam said that she has seen the consequences of being uninsured: Diabetics who end up with thousands of dollars in medical bills, because they cannot afford insulin; people who arrive at the hospital with septic organ failure, because they cannot get infections treated; unhoused people who lose limbs, following frostbite.
“Losing health coverage doesn’t make chronic health illnesses disappear,” Sam said, “it just forces people to go without treatment.”
And when preventable conditions become emergencies, and patients get sicker and have to stay longer in the hospital, she said, “this raises the cost for them and for the hospital, leaving them with debt they can’t repay and with hospital beds that are totally filled up.”
“Without adequate Medicaid funding, we can’t continue to meet the needs of our community,” Sam said. “Cutting Medicaid doesn’t reduce the need for healthcare. It just shifts the costs, creating more illness, more disability, and more unnecessary suffering.”
In the end, she said, everyone pays.
“Our health system is already fragile. It wouldn’t take much to throw it into crisis,” Sam said. “If we want to preserve timely, lifesaving care for all, we need stable funding for every patient, including the poor, the elderly, and the disabled.”
In response to questions from members of the media, Ferguson himself warned in no uncertain terms that “what happened in Congress a few hours ago makes a challenging situation dire … I’m just not throwing that word around.”
“I want to be crystal clear:
It’s dire,” he repeated. “Hospitals will close. Nursing homes will close.
– Gov. Bob Ferguson
That will impact, as you heard, not just folks who are on Medicaid—Washingtonians all across our state.”
“Right now, it is a four-alarm fire. It is all hands on deck,” he continued. “This is something that my team is working on very hard right now in multiple ways, but what’s right in front of us … for the crisis of the moment is this vote in Congress and the … disastrous consequences that will unfold if it goes forward.”