Medicaid Cuts May Limit Opioid Rehab Access in WA

Author

Hayley Wilson

About the Author

Medical Reviewer

Eric Owens

About the Editor

The Big Beautiful Bill, which passed in 2025, included several federal Medicaid cuts that will be implemented this year. Washington’s Health Care Authority (HCA) says these cuts could remove Medicaid coverage for over 320,000 Washington residents who rely on Medicaid for health and addiction treatment services.

These cuts threaten a new pilot program that coordinates efforts between opioid use disorder treatment providers and the Seattle Fire Department’s Mobile Integrated Health Program, which serves people who may not otherwise access addiction therapies.

Low-Barrier Addiction Treatment After Overdose

Overdose is treated with a medication called Narcan. It reverses overdose by blocking the effects of opioids entirely. The trouble with this life-saving medication is that it often introduces withdrawal symptoms immediately, making a person incredibly uncomfortable.

In this pilot program, a person who can administer buprenorphine goes with the first responders as they respond to overdose calls. The goal is to be there as a person is waking up to provide buprenorphine and discuss affordable, ongoing treatment options like outpatient rehab.

This approach allows people experiencing OUD to access treatment without additional barriers, meeting them where they are.

Long-Term Impact on Treatment Access

Washington’s HCA is in the process of determining the federal cuts’ impact on opioid use disorder programs. They manage Medicaid matters for WA residents, giving them an inside understanding of how budget cuts play out in the long run.

HCA plans to coordinate with existing partners to minimize negative effects of the budget cuts. Because the cuts don’t impact overdose responses directly, their concern lies in preserving long-term treatment options.

Medications for OUD, like buprenorphine, are still covered under Medicaid. But these medications are only the first step in a comprehensive treatment program – patients need access to resources that support ongoing treatment plans.

Any cuts to Medicaid coverage that lead to fewer federal funds or increased reliance on unpaid care may threaten opioid treatment providers throughout the state.