A partnership between the federal government and states that provides medical insurance and services for children in low-income households, seniors, people with disabilities, and others with limited income.  Medicaid is paid directly to care providers, not to individuals.

Why Medicaid Matters

• In 2024, 8% of the federal budget was allocated to Medicaid, which serves around 80 million people, or one in five Americans.

• About 1 million people in nursing homes rely on Medicaid. Funding cuts could lead to the closure of facilities, resulting in staff layoffs, homelessness for non-Medicaid residents, business losses for suppliers, and increased unemployment.             

• Approximately 27 million children rely on Medicaid for essential medical care, long-term support, and disability services. Many of these critical services could disappear, exposing children to preventable diseases and leaving families of disabled children to navigate challenges without necessary support.

• Pregnancy care for low-income individuals will be reduced, resulting in more avoidable infant deaths and maternal deaths from pregnancy complications. 

• Hospitals and doctors won't be reimbursed for services to low-income individuals who can't pay, shifting costs to other patients and insurers. This will lead to higher expenses for all seeking care, and if costs can't be absorbed, hospitals will have to limit services, cut staff, or close, especially in rural areas.

• States will have to find funds to continue Medicaid services, leading to higher state income and/or sales taxes.

The recently passed “Big Beautiful Bill” includes major reductions to federal support for long-term care. Here's what’s at risk:

• Fewer beds and longer waitlists

• Reduced services and staff shortages at local facilities

• Closures of smaller care homes in surrounding counties

• Increased reliance on private-pay models, leaving many families behind

What You Can Do—Starting Today

1. Start the Conversation Early
Talk with your loved ones about care preferences, finances, and legal documents. Ask:

• Where would they want to go if care is needed?

• Have they saved enough?

• Do they qualify for Medicaid?

• Is there a power of attorney or advance directive in place?

2. Build a Financial Safety Net

• Consult a local elder law attorney—many offer free or sliding-scale consultations

• Explore long-term care insurance options

• Understand Medicaid eligibility and asset protection strategies

3. Research Facilities Before Crisis Hits

• Identify which Spokane-area facilities still accept Medicaid

• Ask about waitlists and closure risks

• Tour locations and talk to staff

4. Consider Private Pay Entry Points

• Some facilities offer faster admission if you can pay privately for the first year

• Ask about hybrid models or phased payment plans

5. Prepare for Home-Based Alternatives

• Build a care network of family, friends, and neighbors

• Explore Spokane’s home care services, respite programs, and caregiver support groups

• Check with Aging & Long-Term Care of Eastern Washington (ALTCEW) for regional resources