Cantwell, Schrier hear NCW concerns about potential Medicaid cuts

In a conference room at Columbia Valley Community Health’s Behavioral Health Clinic, two members of Congress sat alongside hospital executives, doctors and community health stakeholders from across North Central Washington. Each health care worker at the roundtable warned that Medicaid cuts would cripple rural health care and the communities that rely on it.

U.S. Sen. Maria Cantwell and Rep. Kim Schrier visited Wenatchee on April 17 to hear directly from providers about how proposed cuts to Medicaid and Medicare would impact the region. 

According to the Washington Health Benefit Exchange, 1.8 million Washington residents use Apple Health — the state’s Medicaid program — and about 800,000 of them are children.

House Republicans, including Rep. Dan Newhouse, voted in favor of a resolution directing the House Energy and Commerce Committee to reduce the federal deficit by at least $880 billion.

While Medicaid is not explicitly mentioned in the resolution, both Cantwell and Schrier said the measure would ultimately impact government-funded health care programs like Medicaid. They said the move would lead to service reductions and potential hospital closures.

“You cut Medicaid, and it creates a spiral,” Cantwell said. “First it affects the programs then it affects the hospital, then it affects the workforce. Then you end up with shortages. Then you end up with deserts. Then you end up with, ‘Who wants to have a business there?’ It just keeps cascading.”

Apple Health provides free or low-cost health coverage to low-income individuals and families. It is funded by federal and state governments and managed by the Washington State Health Care Authority.

In 2020, Apple Health covered about 46% of all births in the state, according to the HCA — many in rural counties such as Chelan, Grant, Douglas and Okanogan.

At April 17’s roundtable, health care leaders said cutting Medicaid funding would not only impact low-income patients, but also weaken financially struggling health systems.

“Sixty-six percent of our services are funded by Medicaid,” said Aaron Edwards, CEO of Lake Chelan Health Hospital. “We’re extremely vulnerable. Our operative margin is negative 2%. If it weren’t for local tax revenue, we wouldn’t break even. Cuts to Medicaid would have profound effects.”

Lake Chelan is one of the last remaining small hospitals in the region that still delivers babies. If Medicaid funding is cut, Edwards said maternity services could be the first to go — a concern echoed by Schrier, who has a background as a pediatrician.

“When Medicaid is cut, labor and delivery services are the first to go,” Schrier said. “I am so worried about what that means for this community and rural health.”

Dr. Matthew Hillman, chief medical officer at Lake Chelan Health, said the loss would affect more than just Medicaid patients.

“If you cut Medicaid funding to a rural hospital, the losers are the entire community,” Hillman said. “It’s not just the recipients of Medicaid — it will be everybody in that community that is affected. Especially if that hospital closes its doors.”

Dr. Andrew Jones, CEO of Confluence Health Hospital, said that threat is already materializing in parts of the state, where OB-GYN care has grown scarce. He said his team is often called to support areas that have already lost obstetric services.

“We’re the referral center for OB care in the region,” Jones said. “We’ve worked closely with folks in Okanogan County to stabilize services up there. Family docs are doing C-sections trying to keep the system afloat. And they’re winning, but it’s hard.”

Niekol Hall, a hospitalist and medical director with Confluence Health, said about 30% of its patients rely on Medicaid. Without that support, she warned, the system would buckle.

“They are going to show up to our ERs much sicker, with more advanced disease,” she said. “Our ability to treat and discharge patients will be severely impacted.”

Collectively, health professionals at the roundtable said the economic impact of Medicaid cuts would extend beyond hospitals to the communities they serve. Clark Hansen, chair of the CVCH Board of Directors, said weakening already fragile health systems could ripple through local economies.

“If you take away Medicaid, you make an already fragile system weaker,” Hansen said. “That has a potential economic impact on our community.”

Dr. Felipe Gutierrez, chief medical officer of Columbia Valley Community Health, said the Medicaid population is often misunderstood — and that the program serves a broad range of people.

“There’s a stigma about poverty — like it only applies to people who don’t work or don’t want to,” he said. “But a family of four making under $36,000 qualifies for Medicaid. That’s someone making $15 an hour, trying to do the right thing, raise kids, stay healthy.”

Gutierrez said cuts would mean losing physicians willing to serve in the state’s most rural areas, especially those trained through shared residency programs like the one run by the University of Washington.

“If maternity services shut down, we would lose those doctors,” he said. “They wouldn’t be in Chelan without them.”