How Trump cuts will impact Tri-Cities health insurance, hospitals, Medicaid
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- Trump’s bill slashes Medicaid, risking hospital closures in Eastern Washington.
- Nearly 17 million Americans projected to lose insurance over the next decade.
- Healthcare cuts target Tri-Cities’ seniors, children, and low-income patients most.
Eastern Washington hospitals could close, hundreds of thousands of patients could lose access to Medicaid and health insurance rates are expected to skyrocket, while quality of care gets worse, say medical officials and other leaders.
Experts say the passage of President Donald Trump’s “Big Beautiful Bill” will lead to a crisis for many healthcare providers and patients.
Washington’s 4th Congressional District, which includes the Tri-Cities and much of Central Washington, will be hit harder than most areas of the state because it has the highest rates of patients relying on Medicaid.
The massive bill is guided by spending requests from the White House. It will extend the 2017 Trump tax cuts, while cutting billions of dollars in social program funding. It’s been described as the largest cuts to social welfare programs since at least the 1990s, and according to some experts the most severe in modern history.
The most recent Congressional Budget Office estimate puts the total cost of the Big Beautiful Bill at $3.3 trillion and leaves 11.8 million more Americans without health insurance by 2034.
Some Affordable Care Act tax credits that were not extended in the bill will fall off later this year and add another 5.1 million people to the tally, resulting in nearly 17 million more Americans being uninsured over the next 10 years.
The reality is the cuts will impact everyone.
While some have said the bill only targets undocumented immigrants or able-bodied men who don’t want to work, the largest portion of the cuts will come from increased work requirements. Those changes will primarily hurt women acting as caregivers, according to an analysis from The 19th.
Burdensome expanded paperwork requirements also will lead to more people losing coverage in the first year it goes into effect and make it harder for them to regain coverage. The redetermination reviews would also be more frequent.
Currently, undocumented immigrants are not eligible for Medicaid, and most lawfully present, eligible immigrants must wait five years before applying.
While some undocumented immigrants are eligible for Washington state’s Apple Health Expansion program, those plans are paid through the state and require monthly premiums unless an applicant qualifies for a waiver. The program is extremely limited with only enough funding for 13,000 people in its first year.
Millions of people losing healthcare creates a much larger burden on hospitals, which will in turn raise prices and health insurance costs, say state officials.
Medicaid
Cuts to Medicaid will hit Central Washington harder than any other part of Washington, say state officials.
In the 4th Congressional District 70% of all children are on Medicaid, which is called Apple Health in the state.
That includes 70% of children in Franklin County, 55% of kids in Benton County, 80% of kids in Yakima County and 90% of kids in Adams County.
In the state, three in five nursing home residents and three in eight people with disabilities rely on Medicaid, and it is the largest payer for opioid use disorder treatment, Gov. Bob Ferguson said during a recent Tri-Cities visit.
Nonprofits in the Tri-Cities that help seniors continue living independently or with caretakers at home also be devastated.
Senior Life Resources is 95% funded by Medicaid and helps provide quality of life services to help seniors continue living on their own. Adult Day Services of Tri-Cities is 90% funded by Medicaid and helps disabled adults, veterans and seniors continue living at home with either family or a qualified caretaker.
If their patients lost Medicaid funding, they are likely to end up in the hospital more frequently due to lack of routine and preventative care, and could be forced into skilled nursing facilities.
Meanwhile those facilities are already strained due to rising costs and don’t have the capacity to handle an influx of new patients.
In addition to increased costs due to more complex administrative requirements, the bill also bars states from creating new or raising existing taxes on healthcare providers in order to finance funding gaps.
Hospitals and medical insurance
Experts say cuts to Medicaid will impact the entire medical system, not just the program itself.
Emergency room waits will increase and specialists could be overwhelmed.
The increased burden on hospitals and healthcare facilities will likely lead to private insurance premiums spiking. Sen. Maria Cantwell, D-Wash., said people with employment-based insurance could see an additional cost increase of $282 to $485 a year.
Washington State Hospital Association President Cassie Sauer said in a news release that the bill is a disaster for Washington state hospitals.
She anticipates increased costs and loss of insurance will lead to the closure of some rural hospitals. Prosser Memorial Health and Lourdes in Pasco are designated as rural Critical Access Hospitals.
Sauer also said it will lead to services being scaled back and layoffs at healthcare facilities.
While Republicans secured a $50 billion boost for rural hospitals, estimates show those same hospitals will lost $155 billion in Medicaid spending alone.
Medicare
Cuts to Medicare are estimated to total about $500 billion over 10 years, according to the Congressional Budget Office estimate.
About 1.4 million people who are eligible for both Medicaid and Medicare would lose access to cost-sharing assistance. Programs that help pay Medicare premiums would also be cut.
Many of the cuts to Medicare would impact people who have not yet turned 65, but will in the next 10 years.
Tax credits expected to be used by an estimated 20 million people for help with paying for Medicare would be allowed to expire. Some programs meant to help low-income seniors with affordability also would be impacted.
Most lawfully present immigrants in good standing would also lose access to Medicare.
How will this increase strain on hospitals?
People putting off care will lead to worse health outcomes, say health officials.
For example, if a diabetic patient isn’t getting regular foot care at Adult Day Services of Tri-Cities, they may end up having to receive that routine and preventative care from a variety of specialists or in the emergency room. Then after a trip to the emergency room, they’ll likely be referred out to specialists for follow-up care.
In addition to health outcomes getting worse without preventative care, system funding cuts are going to have a big impact on local healthcare. If rural hospitals close, patients will have to travel further or put off care.
Support staff for those hospitals, primary care physicians and specialists could also be cut as they try to make finances work with more patients no longer insured. Those nurses and other medical professionals are critical to helping manage their already overburdened workload.
Medicare tax credits not being renewed will compound the problem to those turning 65 in the next 10 years. Their costs for care are going to be much higher, leading to more people either uninsured or under-insured.
The area already has much lower access to care than Washington state.
The number of doctors per 1,000 people in 2023 was 2.77 compared to 4.37 statewide, according to Benton Franklin Trends. The uninsured rate in Benton and Franklin counties is also 50% higher than the state average.
Hospital charity care in the area is about 30% higher than the state average, meaning hospitals already are supplementing more uninsured or under-insured patients.
Why are so many children on Medicaid?
The Tri-Cities area has a larger number of children on Medicaid for a variety of reasons. One of the primary factors is that Washington state used Medicaid expansion to achieve one of the lowest rates of uninsured residents in nation.
Children 6 years old and younger are eligible for free Apple Health for families of four making less than about $69,000 per year.
The extreme cost of child care also has left many families having to choose between both parents working and one staying home to take care of kids. The average cost of child care in Washington is now nearly as high as paying for college. With a single income, more children are likely eligible for the free healthcare.
Families can also choose to enroll in paid Apple Health for a much lower cost than most health insurance plans. A family of four making $85,000 a year can pay $40 per month total for both children. Families of four making less than $102,000 annually are eligible for a plan with premiums of $60 per month.
While the Tri-Cities is buoyed by high paying federal jobs, about 57% of jobs in the Tri-Cities area pay less than $55,000 per year, according to Benton Franklin Trends.
The percent of people living in poverty in the area is about 21% higher than the state average.
Planned Parenthood
The bill also includes an attempt to “defund” Planned Parenthood and other certain other healthcare providers, according to Washington Sen. Patty Murray’s office.
It would do so through a provision that would prevent federal Medicaid funding from going to Planned Parenthood and other similar clinics. The provision was pushed through as a one year change in order to skirt rules on policy changes in budgeting.
Murray’s office estimates it puts at least 200 health centers across the country at risk of closure.
About 90 percent of those clinics are in states where abortion is legal. It would cost taxpayers about $52 million over 10 years and 1.1 million Americans would lose healthcare.
The provision notably does not just bar abortion funding. It would also take away access to reproductive care and cancer screening services that many Americans use through Planned Parenthood by blocking all funding to clinics that provide abortions.
County health district
The bicounty Benton Franklin Health District lost $500,000 in preventative disease funding earlier this year.
The state also is expected to lose $160 million in funding for health districts for funding basic services, such as sustaining public health operations, assessments, emergency preparedness and more, according to the Kitsap Sun.
A variety of other public health programs are expected to see reduced funding as restructures and several divisions are closed.
Find the full list of cuts here:
Staff writer Annette Cary contributed to this report.
This story was originally published July 9, 2025 at 5:00 AM.
