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HR1 poses devastating consequences for health care

This action moves us sharply in the wrong direction. It is a massive and cruel betrayal of the American people.
• 2 minutes to read

HR1, which was signed into law by President Trump on July 4, poses devastating consequences for health care. It includes over a trillion dollars in federal healthcare cuts, primarily from Medicaid. The Congressional Budget Office estimates that almost 12 million people will lose health insurance as a result. This means a loss of access to care for many of the most vulnerable, including children, the elderly, and disabled adults.

Washington state will be especially hard hit, losing 17% of its federal Medicaid funding, adding up to $36 billion over 10 years, according to KFF, an independent health policy research group. This means that Medicaid enrollment in Washington could shrink by as much as 26%. An estimated 250,000 Washingtonians may lose Medicaid coverage.

“As nurses, our Code of Ethics mandates us to push for expanding access to health care,” said Justin Gill, DNP, FNP, RN, President of the Washington State Nurses Association (WSNA). “This action moves us sharply in the wrong direction. It is a massive and cruel betrayal of the American people.”

These cuts not only hurt the people who will lose healthcare coverage. The impact will be felt throughout the healthcare system—particularly by rural hospitals and by public hospitals and agencies, as well as nursing homes, all of which serve large numbers of Medicaid patients. The threat to Washington health care will also have ripple effects throughout the Pacific Northwest: many Washington hospitals serve patients from neighboring states. And Seattle’s Harborview Medical Center is the only Level 1 trauma and burn center serving Washington, Alaska, Montana and Idaho.

In the U.S. Senate, both of Washington’s senators, Patty Murray and Maria Cantwell, were vocal opponents of the bill. It passed by a narrow margin in the House. Two of Washington’s representatives, Dan Newhouse (WA-4) and Michael Baumgartner (WA-5), voted for it, ignoring pleas by constituents to resist this assault on health care. Washington’s other eight representatives all spoke out and voted against HR 1.

“WSNA is nonpartisan,” explained Gill, “but we need to hold politicians accountable for their records on critical issues. As the 2026 midterm elections approach, we will remember how our representatives voted on this bill. We won’t forget the representatives who stood with us and our patients, and the only two who turned their backs.”

“While this bill represents a big setback,” said David Keepnews, PhD, JD, RN, FAAN, WSNA’s Executive Director, “we will continue to advocate for our patients and communities. We will work together with our allies to protect healthcare services and safe staffing in Washington. And along with our national partners, AFT and the American Nurses Association—both of whom campaigned hard against these cuts—we will continue to fight against federal policies that threaten access to safe, equitable health care. Despite this loss,” he added, “we’re not deterred. We’re all in this for the long haul.”