‘We’re not cutting costs — we’re shifting them’: KIRO hosts sound the alarm on Washington’s Medicaid crisis

Washington Governor Bob Ferguson signed an executive order this week to help Washington brace for sweeping federal healthcare changes, but KIRO hosts Angela Poe Russell and Jim Dever said the state is fighting an uphill battle against a system designed to quietly push people off their coverage.

The changes stem from H.R. 1, President Donald Trump’s “Big Beautiful Bill,” which cuts more than $1.3 trillion in healthcare and food assistance nationwide, according to the governor’s office. In Washington, the impacts start hitting as soon as next month.

Starting Oct. 1, thousands of lawful immigrants will lose Medicaid coverage, though they can still be treated for emergencies. On Jan. 1, more than 600,000 Apple Health recipients will face new work requirements: 80 hours per month of work, training, or community engagement, along with twice-a-year eligibility checks, according to KOMO News.

Ferguson’s executive order creates a formal response committee, launches a public awareness campaign, and directs the state to build an automated verification system that officials say could help 400,000 people keep their coverage by confirming eligibility without requiring new paperwork every six months, according to the governor’s office.

But if Washington tried to replace everything the federal government is cutting, it would cost an estimated $3.2 billion per two-year budget cycle, according to KOMO News.

“We can’t do all of it,” Angela said on “The Gee and Ursula Show” on KIRO Newsradio.

‘The chaos is the point’: Jim says new Medicaid rules are built to confuse

Jim believes the new rules amount to making Medicaid “less generous and more complicated to use” — and that the complexity is by design.

“If you throw a little chaos into the system, you’re going to lose a few people who are having a harder time keeping up with the new regulations,” Jim said.

He compared the approach to political messaging.

“It’s the difference between good politics and good policy, and everybody’s just looking at the politics,” Jim said. “They just want the soundbite, the headline, the bumper sticker. But when you look at the policy and how it actually affects people, we’re making things more difficult in this computer age when we can be streamlining everything.”

Angela: ‘I pay taxes’ and lawful immigrants are still losing Medicaid coverage

Angela said the part that sticks with her is the impact on lawful immigrants who contribute to the system and are now being cut from it.

“I remember speaking to an immigrant earlier this summer, and she was talking about losing some of these things, and she said, ‘I pay taxes,'” Angela said. “If I move to another country and they’re taking services away because you’re an immigrant, but you’re lawful, and I’m like, I’m paying taxes.”

“They’re not freeloaders,” Jim responded. “They’re part of our system, they’re part of our society.”

Angela also raised concerns about a growing physician shortage and new caps on student loans that are already forcing medical students to drop out.

“My ex-husband would not have been able to go to school without some of those loans,” Angela said.

“My daughter just graduated from medical school a couple of years ago,” Jim added. “She’s carrying a very heavy debt burden as it is. But if she couldn’t have accessed that, there’s just no way.”

Andrew’s mic drop: ‘You are not cutting costs’

KIRO producer Andrew Lanier pushed back on the idea that the federal changes save money.

“When you say, ‘We’re cutting costs,’ you are not actually cutting costs, because people still require medical care,” Andrew said. “What you’re doing is shifting the cost to someone else. And who ultimately picks up that tab? It’s you and I.”

He pointed to the way uncompensated care flows through the system.

“When people have medical needs that aren’t covered by insurance, that is then picked up by the hospital care system. That then returns to us through higher insurance costs,” Andrew said. “So when you see a $23,000 bill for a one-night stay in the hospital, part of what you are paying for is uncompensated care.

“We’re not eliminating a need for medical treatment. We are not eliminating costs for anyone,” he continued. “We are just taking the responsibility for paying that from the federal government to our local hospitals and then to you and I.”

“And that, ladies and gentlemen, is what you call systems thinking,” Angela responded.

Rural hospitals face the biggest hit

Healthcare leaders have warned that rural hospitals will feel these changes the most. At least 200,000 Washingtonians are projected to lose Apple Health coverage by the end of 2027, KOMO News reported.

Washington’s 44 rural hospitals are already operating on thin margins, and rural hospital leaders say the changes will “do irreparable damage to rural healthcare,” according to the Modern Medicaid Alliance.

Ferguson urged Apple Health recipients to check their mail and keep their information current.

Watch the full discussion in the video above.

Listen to Gee and Ursula on “The Gee and Ursula Show” weekday mornings from 9 am to 12 pm on KIRO Newsradio.