Legislative session may focus on backfilling Medicaid cuts

Rep. Bernbaum: State anticipates drop in enrollees

PORT ANGELES — The state Legislature faces a “massive challenge” in its upcoming session.

That’s the message state Rep. Adam Bernbaum, D-Port Angeles, had for the Port Angeles City Council on Tuesday night.

A large portion of the session will be about the state’s response to federal changes in Medicaid, Bernbaum said.

“Kaiser Family Foundation estimates a $4 billion annual hit to Washington state on a biannual basis,” he said. “That’s the equivalent of 10 percent of Washington state’s budget. This is thinking mostly about the first order and most immediate effects. It is not considering some of the second-order effects that are going to come from these policy changes.”

Bernbaum referred to the federal Medicaid cuts included in the One Big Beautiful Bill Act, which President Donald Trump signed July 4. About $1 trillion in Medicaid cuts over 10 years were included in the legislation.

The state estimates a 35 percent to 50 percent reduction in Medicaid enrollment, Bernbaum said.

“We could see premium increase of up to 15 percent,” he said.

The ripple effects of these cuts include increased estimates in uncompensated care, and the state will have to pass a budget to implement its response to the workforce requirement component in the policy.

That response is due from the state by sometime in March, Bernbaum said.

“We aren’t gonna get the definitions for how a lot of the stuff gets rolled out until June 2026,” he said. “This is something that, around the nation, states are trying to figure out. Nobody has the right solution yet, and the size of the financial obligation is so significant that trying to keep us whole is gonna be a massive challenge.”

When the cuts were first announced, Bernbaum and other state legislators initially said “we’re gonna do everything we can to backfill,” he said.

“I think the more honest answer now is we’re gonna do everything we can to backfill, but we won’t be able to backfill everything,” he said. “And that’s gonna mean having some very hard conversations about which services are going to be cut, who we’re going to allow to see increases in premiums and how we can mitigate the fallout.”

Bernbaum’s guess is the Medicaid policy work will “dwarf” any other appropriation considerations the Legislature may have and any other policy considerations, he said.

Mayor Kate Dexter said the council is concerned about what the Medicaid cuts will mean for Port Angeles residents as well as Olympic Medical Center and other health care provisions for people in the community.

Earlier in his presentation, Bernbaum discussed three legislative themes he expects the Legislature to address this upcoming session.

“This is a little bit of speculation and what I’m conveying to you is my sense having conversations with other Democratic and Republican members in the House and Senate,” he said. “Oftentimes, legislative sessions have themes.”

First, he said, he expects the topic of artificial intelligence (AI) to be a policy theme.

“In particular in acting legislation or considering legislation around the use of people’s images or modified versions of people’s images and around the consideration of how AI is gonna impact the security of our elections,” Bernbaum said. “I think there’s a huge amount of regulation that is eventually going to be implemented in this space, and I think that there’s a ton of appetite among legislators to take a crack at it.”

Another topic of discussion will be that of keeping families together.

“So we passed the policy that made it harder to affect separations in Washington state several years ago,” Bernbaum said. “Since that time, we’ve seen a significant increase in fentanyl-related deaths statewide, full stop, for everybody. And we have also seen, in particular among very young children, an increase in fentanyl-related deaths that are, when we go through the analysis, so avoidable.”

This will be a very politically challenging discussion, but “something needs to be done,” he said.

Another topic Bernbaum expects to play out has to do with local revenue support because cities and counties are facing significant shortfalls, especially when it comes to public defense.

“This is an issue I don’t think local jurisdictions can solve on their own, and I think that there’s a growing recognition around this,” Bernbaum said.

With 2026 being an election year, however, Bernbaum said he is skeptical the Legislature will take any action on anything related to revenue or taxation.

Another issue he expects to be discussed is transportation maintenance and preservation funding.

“We have to do something there,” he said. “I don’t believe we have any of it in the current version of the budget. So, given the state of our transportation budget, it’s gonna be pretty challenging.”

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Reporter Emily Hanson can be reached by email at emily.hanson@peninsuladailynews.com.

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