Central and Eastern Washington brace for possible Medicaid cuts
In the 4th District, represented by Republican Dan Newhouse, upward of 70% of those under 19 are enrolled in government-funded insurance programs.
by Mai Hoang
April 3, 2025
On March 19, about 200 people marched in front of The Tower building in Yakima, where U.S. Representative Dan Newhouse’s office is located.
“Do what’s right, do what’s fair, no more cuts to long-term care!” chanted the crowd. “Hey! Hey! Ho! Ho! Cuts to care have got to go!” On a large display, attendees wrote messages explaining why Medicaid funding was important to them and their loved ones. Several people shared publicly their stories of how their health would be impacted by cuts to the government health program.
As the Trump administration and Republican lawmakers move to slash public health programs like Medicaid, marches like the one in Yakima signal disapproval among health care providers, unions and advocates. At the march, organized by a coalition of stakeholders known as Central WA Families, the message was clear: Using Medicaid to balance the budget was going to hurt Newhouse’s constituents.
The event came weeks after House Republicans including Newhouse voted in favor of a resolution that would direct the House Energy and Commerce Committee to cut the federal deficit by at least $880 billion over the next decade. While Medicaid was not explicitly mentioned in the Feb. 25 resolution, advocates say such cuts would be impossible to implement without slashing Medicaid and other government-funded health care programs. And those cuts could be especially devastating in Central and Eastern Washington, where a disproportionate number of residents rely on Medicaid for their health care.
This is a dynamic Nancy Newberry knows well. Newberry traveled to the march from Tieton, a small town nearly 20 miles from Yakima. She said many of her neighbors are on Washington’s Medicaid program Apple Health and that Medicaid funds power health care services in Tieton, including a community-based health care center.
“I do think even small cuts to Medicaid will make those clinics untenable financially,” she said.
Even if there isn’t a formal proposal on the table yet, she said, it’s important that Congressional representatives like Newhouse understand the potential consequences of cutting Medicaid.
“The rural people in this district would be hurt most [if cuts occur] … You have to stand up and say something immediately even if the process is long,” Newberry said. “If you don’t, the process will be finished, you’ll be blindsided, and you never know what was coming.”
A region dependent on Medicaid
In the 2024 fiscal year, more than 300,000 Washingtonians in Newhouse’s 4th Congressional District were enrolled in Apple Health, according to the Washington State Health Care Authority, which operates the state’s Medicaid program. That’s almost 40% of district residents, well above the 25% of individuals enrolled statewide.
Among those under 19 in the 4th District, a whopping 70% —165,075 people — were enrolled in Apple Health. That’s well above the 47% of those under 19 statewide.
In the neighboring 5th Congressional District, which includes Spokane and nearby rural Eastern Washington counties, 30% of Washingtonians — 237,567 individuals — are enrolled in Apple Health. More than half of residents under 19 — nearly 135,000 people — get their health care coverage through Medicaid.
Those numbers are in line with what individual health care facilities report.
A high percentage of the more than 400 births in Adams County’s Othello Community Hospital in a typical year are paid for by Medicaid — roughly 70% to 75% of OB-GYN services offered at the 4th Congressional District hospital are funded by the program, according to CEO Connie Agenbroad. And according to the Washington State Department of Health, 58% of the payers at the hospital are covered by Medicaid, according to Washington State Department of Health figures.
“We have a lot of hard-working people [who] work for farms, orchards and vineyards,” said Brian Giles, chief financial officer for Othello Community Hospital. “Our community is made up of lots of people working hard who are not offered health care or cannot afford health care.”
Medicaid reimbursements don’t fully cover the costs of these services. Even with higher reimbursement rates in recent years, a hospital receives only about 85 cents for each dollar it spends on services, said Jacqueline Barton True, vice president of advocacy and rural health for the Washington State Hospital Association.
Hospitals often have to find ways to make up the difference, usually by leaning on service lines that are generally covered by private insurance, such as orthopedics, she said.
Still, with rising costs of labor and other supplies, many hospitals are already on the edge financially, particularly those in small rural areas, Barton True said.
“When you have to let a nurse go, have to reduce a service, or heaven forbid close a service, the whole community loses that access,” she said.
Finances have stabilized a little in recent years, partially due to funds provided during the COVID-19 pandemic and improved Medicaid reimbursement rates.
Two years ago, the state legislature passed a safety net provision that allowed hospitals to tax themselves on non-Medicaid services. The funds can be used to increase matching funds for additional federal Medicaid dollars. For participating hospitals, the move resulted in increased reimbursement rates and a reduction in overall losses, said Beth Zborowski, senior vice president of membership engagement and communications for the Washington State Hospital Association.
But significant cuts to Medicaid could put a handful of hospitals in danger of closing again, she said.
And even for hospitals not at risk of closing, the cuts could still cause strain. Even now, some hospitals have to use funds meant for capital improvements to keep beds and vital health care services accessible, Zborowski said.
Providing a voice
Last month, a resident at Good Samaritan Health Care Center, a skilled nursing facility in Yakima, saw a familiar face while watching the news on television.
Joany Schimmelfennig, an administrator at Good Samaritan, shared a recent encounter with a resident excited to see her speaking to television reporters during the march outside of Newhouse’s office. During the TV interview, Schimmelfennig explained why Medicaid funds were important to her.
The resident was thrilled. “‘And she goes, ‘You let them know we have a voice too. And they need to know that, how important [Medicaid] is,’” Schimmelfennig recalled. “That meant something to me; that I’m not doing this for nothing. I am doing this for them.”
Schimmelfennig said she hasn’t often spoken out publicly, but she felt called to say something about the prospect of cuts that would negatively impact long-term care facilities like the one she runs.
In 2024, 50 of the 92 people who stayed at Good Samaritan — 54% of them — were covered by Apple Health. While Medicare covers most stays at skilled nursing facilities like Good Samaritan, if a visit extends beyond 20 days, many residents will use Medicaid to cover additional days of care, Schimmelfennig said.
Massive cuts to Medicaid would likely mean many facilities like Schimmelfennig’s would have to accept fewer patients, because they would not have the staffing or resources to care for as many people, she said.
And with Medicaid making up a significant portion of the money needed to operate the facility, cuts could impact all patients, not just those on Medicaid, she said.
Reduced capacity can impact other parts of the health care system. If a skilled nursing or assisted living facility has fewer beds available, patients will occupy hospital beds longer, which means fewer beds available for new patients seeking hospital care.
“I’d imagine we’ll see [more] boarding in emergency departments because there’s not a bed to go to,” said Zborowski of the Washington State Hospital Association.
Continued advocacy
Concerns about Medicaid cuts have reached the state’s Congressional delegation. Sen. Maria Cantwell, D-Seattle, visited several health care facilities throughout Washington state last month. She also compiled reports that illustrated the impact Medicaid cuts would have on residents of Central and Eastern Washington.
Cantwell said she had heard from numerous health care providers that the health care system in Central Washington “would be devastated by these proposed cuts.”
“I guarantee you: Health clinics would close, hospitals would find it hard to provide care, and as individuals have said here, people just would not get health care,” Cantwell said during a news conference following a roundtable of health care providers at Kadlec Regional Medical Center in Richland on March 21.
Cantwell urged Washingtonians to call their Congressional representatives and Senators and the White House and urge them to reconsider cuts to Medicaid.”
Among those contacting the White House is state Rep. Michelle Caldier, R-Gig Harbor, who sent a letter to President Donald Trump urging him to reconsider Medicaid cuts. Caldier said she understands it’s important to examine government waste and other reforms to health care programs, but the solution is complex.
She noted that the cost of living in Washington state is so high that even residents living above the poverty line struggle to pay health care costs and may need assistance from a program like Apple Health. She also said that many federal workers, including those in her district, are losing their jobs, and need to be given time to find new employment before transitioning away from government-funded health insurance.
“At the end of the day, it’s going to end up on [Trump’s] desk; he holds a lot of power,” Caldier said. “I hope he’ll give it a second thought before cutting funding.”
In March, while Congress was in recess, Newhouse recently visited Astria Toppenish Hospital. He also wrote an op-ed in the Yakima Herald-Republic, published on March 26, assuring that “cutting resources to those who rely on these [Medicaid, Medicare and SNAP] services” is not his aim.
He said he wanted to address “improper payments” to those programs. Citing figures from the Government American Office, he said he wanted to address $162 billion in improper payments last year, including $54.3 billion and $16 billion in improper payments for Medicare and Medicaid, respectively. Addressing this issue is important for ensuring these programs “remain solvent for low-income families and our seniors who rely on them,” he said.
Carma Matti-Jackson, CEO of Washington Health Care Association, the trade association representing assisted living and skilled nursing facilities, said in a written statement that while she is glad to see a commitment from Newhouse to protect Medicare funding, she and other members of the Central WA Families coalition, the group that organized the march and rally outside Newhouse’s office, said they remain concerned about his support for the budget resolution that could bring massive Medicaid cuts.
“Such cuts would directly harm millions of people, many of whom call his district home,” Matti-Jackson said. “As Medicaid funding continues to be debated by Congressman Newhouse and his colleagues in Congress, we will continue advocating on behalf of those who rely on this funding for their basic health care needs.”
Barton True of the Washington State Hospital Association said it “defies logic” to claim that there is $880 billion in Medicaid fraud and abuse. The association plans to challenge this narrative and illustrate the reality that numerous people depend on Medicaid to get health care.
Indeed, Giles, the CFO at Othello Community Hospital, said he does not buy into the narrative of excessive waste and fraud that justify massive Medicaid cuts. “We see real people coming in [to have] babies,” he said.
Barton True said staff members of the Washington State Hospital Association have met with every member of Washington’s Congressional delegation; most have been supportive.
However, Barton True said she and others at the Association are waiting for more tangible proposed cuts so they can fully understand the impact.
While political will from Republicans will determine how fast the budget process goes, Barton True still believes it will be several months before lawmakers drop their proposals on cuts and take tangible actions.
When that happens, the real advocacy work will begin, Barton True said. “That conversation is going to come, and we’ll be ready for it.”