Medicaid cuts would hurt hospital, patients

NEWPORT – Significant cuts to Medicaid, the federal program for disabled and low-income people, would have devastating effects on individuals, working families, hospitals, clinics and many services, hospital spokesperson Jenny Smith wrote in an email in response to questions from The Miner.

“These cuts would have a particularly large impact on the Pend Oreille River Valley because we have high usage of Medicaid,” Smith wrote. “People think of Medicaid as an urban program, but the percentage of people using Medicaid in rural communities is much higher than in urban communities. Newport Hospital and Health Services also accepts Idaho Medicaid to serve our neighbors across the border.”

On Feb. 13 the U.S. House Budget Committee voted to seek at least $880 billion in mandatory spending cuts on programs overseen by the House Energy and Commerce committee, according to Kaiser Family Foundation Health News. That committee oversees Medicaid, which is expected to bear much of the cuts, KFF reported. Senate Republicans, working on their own plan, have not proposed similar deep cuts.

The House narrowly passed a Republican budget resolution Feb. 26 that would significantly reduce funding to Medicaid.

U.S. Rep. Michael Baumgartner, R-Spokane voted for the measure, which passed 216-214. Baumgartner, who represents Pend Oreille County along with most of Eastern Washington, did not respond to questions from The Miner, but told the Spokesman-Review that states are responsible for how Medicaid funds are spent. In a Feb. 27 Spokesman-Review story reporting the passage of the resolution, Baumgartner called Medicaid “a broken system that does not serve the most needy well or in a sustainable way.”

“Not only is the system broken and in need of reform, the reality is that America is broke,” Baumgarten told the Spokesman-Review. “We are $37 trillion in debt and are spending more money on debt payments than we are on national defense, so the economic reality and responsibility has set in, and that is going to require some needed reform to Medicaid.”

Russ Fulcher, who represents North Idaho and sits on the Energy and Commerce Committee, said he and his fellow Republicans don’t intend to cut benefits for what he called the “traditional Medicaid population,” including children and people with disabilities, The Spokesman-Review reported in its Feb. 27 story.

“We’re trying to get a handle on what can be done without cuts,” Fulcher said in the Review’s story, suggesting that GOP lawmakers may start by adding work requirements for adults who can work and capping Medicaid spending so that it doesn’t increase with inflation and population growth.

“I think there’s a real sensitivity to making sure the traditional population is not impacted,” he said. “But on the other hand, there is controversy – always has been – on the expansion population of working-age, able-bodied adults.”

The budget resolution now goes to the U.S. Senate, which is writing its own budget resolution that doesn’t include such steep cuts as the House resolution. Republicans have the majority in the House and Senate.

For a budget resolution to have force and effect, according to the Congressional Research Service, the House and Senate must adopt identical language. Congress can reach agreement one of three ways: by conference committee, via an exchange of amendments, or by one chamber adopting the budget resolution of the other without any changes.

Newport Hospital and Health Services is reimbursed an average of $1.3 million a month in Medicaid payments for hospital and clinic services, Newport Hospital and Health Services spokesperson Smith said. That’s about 20% of NHHS’s revenue. Children (birth through age 17) make up 28% of the Medicaid patients.

“Some of our most vulnerable residents, including people with disabilities and newborn babies, also get the lifesaving care they need through Medicaid,” Smith wrote.

The Idaho state legislature is also considering Medicaid cuts.

“Medicaid expansion basically is on the chopping block in Idaho,” NHHS Chief Executive Officer Kim Manus said at the hospital district’s commissioners’ Feb. 27 board meeting. The Idaho Legislature is talking about rolling back the Medicaid expansion approved by a citizens’ initiative in 2018 and bringing it back to pre-expansion levels.

Manus said as Idaho people lose Medicaid coverage, when they come to Newport Hospital and Health Services for treatment and care they become charity care write offs when they cannot pay because of low incomes.

“That means instead of getting paid our costs to take care of them, we don’t get anything,” Manus said.

Manus said charity care write offs were $990,000 in 2024. Manus said more out of state patients received charity care than in state patients.

Smith said many people who use Medicaid may not realize they have it. Apple Heath and Apple Health for Kids receives care through Medicaid.

“We think it is important that people understand their care could be at risk,” she said.

Smith said any cuts to Medicaid would likely result in the hospital cutting services, especially services that are expensive to provide with little reimbursement.

“The impact of these cuts would not be limited to just Medicaid beneficiaries, as reduced funding anywhere in the system stresses the availability of services for everybody,” Smith said.