NorthwestMarch 8, 2025

If the federal government cut Medicaid spending, it could force states to pick up the tab

Jerry Cornfield Washington State Standard
Speaker of the House Laurie Jinkins speaks during the inauguration of Gov. Bob Ferguson on Wednesday, Jan. 15, 2025, at the Washington State Capitol in Olympia, Wash. (Ryan Berry/Washington State Standard)
Speaker of the House Laurie Jinkins speaks during the inauguration of Gov. Bob Ferguson on Wednesday, Jan. 15, 2025, at the Washington State Capitol in Olympia, Wash. (Ryan Berry/Washington State Standard)Ryan Berry

The leader of the Washington state House of Representatives said the quiet part out loud this week: lawmakers should brace for a special session if Congress slashes funding for Medicaid, the health care program for lower-income Americans.

“We’re on a plan to finish our work by Sine Die. If they just decimate Medicaid, there’s no way to plan for that,” House Speaker Laurie Jinkins, D-Tacoma, told reporters on Wednesday. Such a move, she said, would put Washington and the rest of the country “in completely uncharted territory.”

The state Legislature is in the midst of a 105-day session that is scheduled to end April 27. Finishing on time is already going to be a challenge as legislators and Gov. Bob Ferguson wrestle with how best to plug a roughly $6 billion hole in the next two-year state budget.

Meanwhile, the Republican-led U.S. House passed a budget last week that assumes an extension of the 2017 tax cuts and $880 billion in reduced spending from an array of programs that include Medicaid and Medicare.

If the federal government pares back its Medicaid spending, it could force states to pick up the tab. Rural hospitals would be affected too as they rely heavily on Medicaid and Medicare dollars.

For Washington, backfilling the potential cuts could amount to several billion dollars a year depending on what the state would want to cover and could afford to pay for.

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Washington received more than $12.5 billion in federal Medicaid funding in the 2023 fiscal year, according to U.S. Sen. Maria Cantwell, D-Washington. Total spending in the state operating budget was on track to be around $37 billion this fiscal year.

U.S. Sen. Patty Murray, D-Washington, with whom Jinkins spoke recently, last week outlined several potential consequences of Medicaid cuts.

For example, if the federal government stops providing matching funds to states like Washington that expanded Medicaid under the Affordable Care Act, it would force Washington to spend $2.8 billion to maintain coverage for about 647,000 people.

With so much uncertainty, Jinkins said no state can plan for what might occur.

“The way that we’re thinking about this is: What do we need to do to balance our budget, and know there’s the potential that there are Medicaid implications to that?” she said.

As to adjourning on schedule, she said, “I really don’t know where we’ll be should the federal cuts happen.”

Jerry Cornfield joined the Standard after 20 years covering Olympia statehouse news for The Everett Herald.

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