WASHINGTON D.C. – A federal budget reconciliation bill, formally known as the One Big Beautiful Bill Act of 2025, narrowly passed the U.S. Senate this week, a legislative action projected to result in significant cuts to national healthcare programs.
The bill’s passage is estimated to cause more than 31,000 residents of Washington’s 3rd Congressional District, an area encompassing Clark County, to lose health coverage.
Legislative Action and Narrow Passage
The One Big Beautiful Bill Act of 2025, originating in the House of Representatives, advanced to the Senate where voting commenced on Monday, May 13, 2024. After deliberations, the bill secured passage on Tuesday, May 14, 2024, by a razor-thin margin of 51-to-50, underscoring the contentious nature of the legislation and its proposed spending adjustments.
Projected Medicaid Cuts
A key component of the newly passed legislation is a substantial reduction in funding for Medicaid, the federal and state program providing healthcare to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities. According to a news release issued Sunday, May 12, 2024, by the office of U.S. Sen. Maria Cantwell, a Democrat representing Washington, the bill proposes cuts totaling a staggering $930 billion from the Medicaid program.
These proposed cuts are anticipated to have widespread consequences across the nation. Estimates cited in Senator Cantwell’s news release suggest that the reduction in funding could lead to as many as 16 million Americans losing access to crucial healthcare services provided through Medicaid.
Statewide and Local Impact
Within Washington state, the impact of the federal policy change is expected to be significant. Senator Cantwell’s office projects that more than 300,000 Washingtonians statewide could lose access to healthcare as a result of the measures included in the One Big Beautiful Bill Act of 2025.
The consequences are particularly focused on specific regions within the state. Washington’s 3rd Congressional District, which covers a large portion of southwestern Washington and includes the heavily populated Clark County, is projected to bear a substantial burden of these cuts. According to detailed estimates, 21,654 residents specifically within the 3rd District are projected to lose their Medicaid coverage following the implementation of the bill’s provisions.
Separate analyses, reflected in initial reports surrounding the legislation, estimated that the total number of 3rd District residents potentially losing health coverage more broadly could exceed 31,000.
Relevance to the Border Region
The implications of this federal legislative change extend beyond state lines, holding particular relevance for communities situated along the Washington-Oregon border. For residents in this area, served by publications like The Columbian, changes to federal programs such as Medicaid can directly impact access to healthcare services, regardless of which side of the Columbia River they reside on. Federal healthcare policies often influence state-level program structures and funding, making the effects of significant cuts potentially felt across the border region as a whole.
Perspectives on the Cuts
The news release from Senator Cantwell’s office highlighted concerns regarding the potential impact on vulnerable populations who rely on Medicaid for essential medical care, including doctor visits, hospital stays, long-term care, and preventive services. The substantial reduction in funding raises questions about the future availability and accessibility of these services for millions nationwide and tens of thousands within Washington and the 3rd Congressional District.
The passage of the One Big Beautiful Bill Act of 2025 represents a significant policy shift with far-reaching consequences for healthcare access in the United States. As the provisions of the bill are implemented, the projected loss of health coverage for thousands of residents in Washington’s 3rd Congressional District and millions nationwide will become a critical point of focus for policymakers, healthcare providers, and affected families.
