SEATTLE — In July 2025, President Donald Trump signed the Big Beautiful Bill into law. It’s estimated to cut federal Medicaid spending by $1 trillion over the next decade.
Washington state spends about $21 billion dollars on Medicaid each year, with more than half of that funding coming from the federal government; now, the state expects to lose billions of those dollars from D.C.
SEE ALSO | Millions could face coverage loss under new Medicaid work rules
The most recent state budget does try to make a dent, spending $165 million to directly mitigate the costs of the bill.
But several changes, aside from spending cuts, are coming to the program in just about six months.
By December 31 of this year, the state must implement new work requirements for Medicaid eligibility. That means Americans between ages 19-64 have to be working, attending school, or volunteering at least 80 hours each month to maintain coverage.
A recent survey by the Health Management Academy shows that 55% of Medicaid enrollees are completely unaware that work requirements are around the corner; an additional 27% say they have heard something but don’t know the details.
And proof of eligibility will be required every six months, too, rather than annually, something 85% of enrollees do not know.
Compared to other states, Washington Medicaid enrollees are slightly more educated, with 51% percent unaware of the newly passed work requirements. The national average, according to the survey, is 55%.
Before those work requirements kick in, the first big date is in October when an estimated 30-thousand Washingtonians, who are refugees or asylees, will lose coverage.