New Medicaid rules cut coverage for 11,000 in Washington state
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About 11,000 Washington residents lost Medicaid coverage this month because of changes Congress approved last year, with many more expected to lose health insurance in the coming months.
The big picture: State officials predict at least 200,000 more Washington residents will be kicked off Medicaid by the end of 2027 because of H.R. 1, which President Trump dubbed the "big, beautiful bill."
Zoom in: The estimated 11,000 people who lost coverage in Washington on Oct. 1 include immigrants who are legally in the U.S., but who are not permanent residents.
- Refugees, trafficking victims and people granted asylum are among those who no longer qualify for coverage, according to the Washington State Health Care Authority.
Catch up quick: H.R. 1 limited Medicaid eligibility for immigrants, restricting coverage to lawful permanent residents, Cuban or Haitian immigrants, and Compact of Free Association islanders.
- The law also imposes new work requirements that put more than 600,000 Washington residents at risk of losing coverage when that part of the bill takes effect in January, according to state estimates.
What they're saying: Many of the people losing coverage will have "no choice but to turn to emergency departments for care, leading to longer wait times for everyone," Ryan Moran, director of the Washington State Health Care Authority, said in a written statement to Axios.
- "Hospitals, clinics, and community health centers will face difficult decisions about what services they can continue to provide, affecting entire communities, especially in rural areas," Moran added.
The other side: The Trump administration has defended the new Medicaid requirements.
- The narrower immigrant eligibility rules are intended in part to "safeguard taxpayer dollars," Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, said in a news release this year.
- Oz also said the work requirements will help Americans build "skills and independence through work, education, job training or community service."
State of play: State officials say they're working to help as many as 400,000 Washington residents keep Medicaid coverage once the new work requirements take effect next year.
- The state is building an automated verification system, which will use existing state data to determine whether recipients meet the requirements or qualify for an exemption.
- That will reduce the need for people to submit paperwork every six months to prove they're working, volunteering or participating in another qualifying activity.
- "Every additional form or documentation requirement creates another opportunity for someone to lose coverage because the process is too difficult," Katie Pope, spokesperson for the Washington State Health Care Authority, wrote in an email to Axios.
Yes, but: Even with those efforts, state officials estimate at least 200,000 Washington residents will lose coverage when the work requirements kick in next year.
What's next: The state expects Medicaid coverage changes to unfold gradually through 2027 as people renew their coverage and the new requirements are applied.