OLYMPIA — As Democrats prepare to regain control of Congress in January, state and federal lawmakers in Washington have identified reversing billions of dollars in Medicaid funding cuts, which could leave hundreds of thousands of Washingtonians without healthcare coverage, as a top legislative priority.
But with two years remaining in President Donald Trump's term, lawmakers wonder how the president would respond if legislation reaches his desk.
Some of the cuts, which Republicans passed in the One Big Beautiful Bill Act in July 2025, have already taken effect. Last month, around 10,000 immigrants in Washington, including refugees and asylum seekers, lost Medicaid coverage, which is known as Apple Health in the state.
In Washington, more than 1.9 million residents are covered through Apple Health, which includes 15% of adults and 36% of children.
With steeper cuts set to take effect in January, state lawmakers have repeatedly warned for more than a year that they can't absorb the loss in federal funding without cutting services.
"In taking back Congress and the Senate, I don't think that's just a good thing for our country, but for Washington state specifically, it's huge, OK?" Gov. Bob Ferguson told reporters Wednesday. "Because, back to our budget, as you all know, we have some severe budget challenges, in large part, because of draconian cuts from HR1 to Washington state. That includes Medicaid cuts in the billions of dollars, to give just one example."
The federal legislation included cuts to Medicaid funding of up to $1 trillion over the next decade through stricter work requirements and stringent enforcement measures that critics say create barriers for residents to access the program.
Prior to federal cuts, Washington spent about $21 billion on Medicaid annually, $13 billion of which is paid by the federal government. Under the One Big Beautiful Bill Act, Washington stands to lose about $3.2 billion over two years, which could result in at least 250,000 Washingtonians losing their coverage.
An analysis published by the nonpartisan health research organization KFF before the bill's formal passage found that Washington is among the states hardest hit by the legislation. The Washington attorney general's office, which filed a lawsuit Thursday seeking to block the cuts from taking effect, said at least 20% of Washington residents could lose coverage due to the changes.
"This administration's changes to Medicaid are the latest cruel effort to shred the safety net for tens of thousands of Washingtonians," Attorney General Nick Brown said in a statement. "This red tape will make people lose their health insurance, stop going to the doctor when they're sick, and rely on our public hospitals for emergency care when inevitable health issues spiral out of control."
As he celebrated Democrats' victories across the country on Tuesday, House Democratic leader Hakeem Jeffries, who could become speaker of the House in January, said Democrats would "fight to reverse these painful Medicaid cuts."
During an event in Bellevue last year, Jeffries called the cuts to Medicaid the "biggest" in U.S. history and said it could result in "tens of millions" of Americans losing coverage and the closure of hospitals and health clinics across the country.
State leaders in Washington have taken notice of the effort to potentially restore the funding.
"On my drive down today, I saw a headline from one of the newspapers saying Democrats are already talking about addressing them when they go back to Congress next year, to restore that funding for Medicaid for the states that are hard hit all across the country," Ferguson said Wednesday. "So, I'm really, really encouraged, to put it mildly, very encouraged by, across the country, Democrats taking back control of the House and the Senate, which will have huge positive impacts for the people of the state of Washington."
Sen. Patty Murray, the top Democrat on the Senate Appropriations Committee, said in an interview that during the election voters sent a "really strong message about bringing down costs."
"The issue I hear in Washington state constantly is the so-called Big Beautiful Bill cuts to Medicaid and to SNAP, and that we need to fight to reinstate those provisions so that our healthcare costs don't continue to go up," Murray said. "Will the president veto it, or will he work with us? That is really up to him, but we will fight for that."
Rep. Marilyn Strickland, D-Tacoma, said restoring cuts to Medicaid is part of Democrats' "anti-cruelty agenda" that also includes restoring Affordable Care Act subsidies that expired last year,
Rep. Kim Schrier, D-Sammamish, a pediatrician, said that restoring the cuts to Medicaid is her top priority, along with restoring the Affordable Care Act tax credits and cracking down on big insurance abuses.
As state lawmakers prepare to return to Olympia in January, they will be faced with an already troubling budget situation, leaving little room in the state budget to make up for the federal cuts. While lawmakers are awaiting one final revenue forecast before the session begins, the governor, who will submit a budget proposal next month, said it's "more than fair to say" the deficit will be in the billions.
State Sen. Marcus Riccelli, D-Spokane, said in an interview Friday that with lawmakers entering a 105-day legislative session, they "have a number of months" to see if and how the federal government addresses the healthcare funding cuts.
"We do have to balance our budget in a two-year biennium and a four-year outlook, and so that makes it extremely challenging," Riccelli said. "And so, obviously we want to navigate and mitigate this as much as possible."
While Riccelli said state officials are doing "great work" to reduce the impacts of the cuts and help Washingtonians maintain their coverage, the state is not able to backfill the funding cuts.
"I don't see ways that we can absorb billions of dollars right now. So, we're going to have to make tough decisions come January," Riccelli said. "I think the side is, we have some time. So Congress does, from our standpoint, have 105 days that we can be watching to see if they can act, and we can react to that. And hopefully bringing back and restoring the enhanced Affordable Care Act health insurance subsidies and reversing Medicaid cuts is on the table."
Riccelli said he spoke with U.S. Sen. Maria Cantwell on Wednesday about the healthcare funding cuts.
"I think they absolutely want to figure out a way to move on restoring the insurance subsidies and are very cognizant of the impacts of Medicaid cuts and looking to reverse them," Riccelli said.
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