Report on the Impact of Federal Healthcare Funding Reductions on Sustainable Development Goals in Washington State

Executive Summary: Legislative Context and Threats to SDG Attainment

Recent federal legislation enacting significant reductions in healthcare funding presents a substantial challenge to Washington state’s progress toward several United Nations Sustainable Development Goals (SDGs). These cuts, primarily targeting the state’s Medicaid program (Apple Health), threaten to reverse gains in public health, poverty reduction, and equality. The current fiscal landscape jeopardizes state-level efforts to achieve universal health coverage and protect vulnerable populations, directly impacting SDG 1 (No Poverty), SDG 2 (Zero Hunger), SDG 3 (Good Health and Well-being), and SDG 10 (Reduced Inequalities).

Statewide Ramifications for Core SDG Targets

The federal funding cuts are projected to have wide-ranging consequences across Washington, undermining foundational social support systems and progress on key SDG indicators.

• SDG 3 (Good Health and Well-being): The state’s ability to ensure healthy lives and promote well-being is at risk. Projections indicate the uninsured rate could more than double from 5%. In Washington’s 2nd Congressional District alone, 186,000 people are at risk of losing Medicaid coverage, directly contravening the principles of universal health coverage (Target 3.8).
• SDG 1 (No Poverty) & SDG 10 (Reduced Inequalities): The financial stability of low-income households is threatened. The potential expiration of premium subsidies by December 31, 2025, could cause insurance premiums to rise by an average of $1,460 annually for 34,000 people. This, combined with new Medicaid work requirements, disproportionately impacts those with the fewest resources, exacerbating poverty and inequality (Targets 1.3 and 10.4).
• SDG 2 (Zero Hunger): Food security for vulnerable residents is compromised. Changes to the Supplemental Nutrition Assistance Program (SNAP), including new work requirements and a shift in cost-sharing to the state, will impact the nearly 25,000 SNAP users in Whatcom County and challenge efforts to end hunger (Target 2.1).

Analysis of Impact on Regional Healthcare Providers

Local healthcare providers in Whatcom and Skagit counties are preparing for the downstream effects of these funding changes. Their responses and projected challenges highlight the localized impact on SDG attainment.

1. PeaceHealth St. Joseph

   As Whatcom County’s sole hospital, PeaceHealth anticipates a surge in emergency department visits for primary care needs, a less efficient model that undermines efforts for sustainable health systems under SDG 3. With 20% of its patients covered by Medicaid, the hospital faces significant financial pressure. Potential cost-shifting measures or service cuts to less profitable programs could reduce access to care for lower-income individuals, further straining progress on SDG 10 (Reduced Inequalities). The organization has not ruled out staff reductions, which would impact SDG 8 (Decent Work and Economic Growth).

2. Skagit Regional Health

   The network, which received $90 million in Medicaid payments in 2024, faces tens of millions in potential losses. This directly threatens specialized services with high Medicaid utilization, impacting several SDGs:

   • SDG 5 (Gender Equality): Women’s health services, with 72% of patients on Medicaid, are at high risk.
   • SDG 3 (Good Health and Well-being): In-patient mental health (56% Medicaid) and children’s therapy (65% Medicaid) face significant potential impacts.

   While the system has no plans for immediate, across-the-board layoffs, its selective approach to rehiring could affect local employment and service capacity, relevant to SDG 8.

3. Unity Care NW

   This Federally Qualified Community Health Center (FQHC) exemplifies SDG 17 (Partnerships for the Goals), having been formed in response to previous federal cuts. With nearly two-thirds of its patients on Medicaid, Unity Care NW is committed to its mandate of providing care regardless of income, directly supporting SDG 1 and SDG 10. The organization expects no service cuts but anticipates an increased demand, planning to repurpose staff to help patients navigate new administrative hurdles. This proactive approach demonstrates institutional resilience in pursuit of SDG 3.

4. Planned Parenthood

   The organization expects no service reductions at its regional clinics, which serve 8,200 patients. With nearly 50% of its patients using Medicaid, its continued operation is vital for SDG 5 (Gender Equality), specifically ensuring access to sexual and reproductive health services (Target 5.6), and for providing broader healthcare access under SDG 3.

5. Family Care Network

   This independent network, serving 105,000 patients, does not anticipate service reductions or layoffs despite 14% of its patients being on Medicaid. Its stability provides a crucial backstop for maintaining community health infrastructure in line with SDG 3.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article discusses issues related to healthcare access, affordability, and nutrition, which directly connect to several Sustainable Development Goals (SDGs). The primary goals addressed are:

• SDG 3: Good Health and Well-being: This is the most prominent SDG, as the article’s central theme is the impact of federal funding cuts on health insurance coverage (Medicaid, ACA), healthcare services, and the financial stability of healthcare providers.
• SDG 2: Zero Hunger: The article explicitly mentions cuts to the Supplemental Nutrition Assistance Program (SNAP), which is a critical program for ensuring food security for low-income residents.
• SDG 1: No Poverty: The potential loss of health insurance and increased healthcare costs (higher premiums) can lead to significant financial hardship and push individuals and families into poverty. Medicaid and SNAP are social protection systems designed to prevent this.
• SDG 10: Reduced Inequalities: The article highlights that the funding cuts disproportionately affect vulnerable and low-income populations who rely on Medicaid, thereby exacerbating health and economic inequalities. It also points to specific services like women’s health and children’s therapy being most at risk.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, the following specific SDG targets can be identified:

SDG 3: Good Health and Well-being

• Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. The article directly addresses threats to this target by detailing how funding cuts will lead to a higher uninsured rate, loss of Medicaid coverage, and increased premium costs, thereby reducing access to healthcare and increasing financial risk for citizens.
• Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services. The mention of Planned Parenthood and the services it provides to 8,200 patients, a significant portion of whom use Medicaid, connects the funding cuts directly to this target.

SDG 2: Zero Hunger

• Target 2.1: By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations… to safe, nutritious and sufficient food all year round. The article’s discussion of changes to SNAP, which serves nearly 25,000 residents in Whatcom County, directly relates to this target of ensuring access to food for vulnerable populations.

SDG 1: No Poverty

• Target 1.3: Implement nationally appropriate social protection systems and measures for all… and by 2030 achieve substantial coverage of the poor and the vulnerable. The article focuses on the cuts to Medicaid and SNAP, which are key social protection systems in the United States. The risk of 186,000 people losing Medicaid coverage is a direct threat to this target.

SDG 10: Reduced Inequalities

• Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… economic or other status. The article shows how the policy of cutting funds will disproportionately harm low-income individuals who rely on Medicaid, threatening their social and economic inclusion by limiting access to essential health services.
• Target 10.3: Ensure equal opportunity and reduce inequalities of outcome… The article implies that these cuts will increase inequalities in health outcomes, as lower-income individuals will find it “harder… to access care” and services with high percentages of Medicaid patients (women’s health, mental health, children’s therapy) are most at risk.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several quantitative and qualitative indicators that can be used to measure the impact on the identified targets.

Indicators for SDG 3 (Good Health and Well-being)

• Uninsured Rate: The article states, “The uninsured rate of Washingtonians is likely to more than double from nearly 5% in 2023.” This is a direct indicator for measuring health coverage (Target 3.8).
• Number of People Losing Coverage: Specific figures like “186,000 people at risk of losing Medicaid” and “nearly 80,000 Washingtonians are at risk of losing health insurance” serve as direct indicators of declining coverage (Target 3.8).
• Healthcare Affordability: The projection that “34,000 people… will see premiums jump by an average of $1,460 a year” is an indicator of increasing financial risk and reduced affordability (Target 3.8).
• Population’s Reliance on Medicaid: The article provides the percentage of Medicaid patients at various facilities (e.g., “Nearly 20% of the hospital’s patients are covered by Medicaid” at PeaceHealth; “nearly two-thirds of their patients on Medicaid” at Unity Care NW), indicating the scale of the population affected by cuts (Target 3.8).
• Access to Reproductive Health Services: The number of patients served by Planned Parenthood (“8,200 patients in 2024”) and the proportion on Medicaid (“Nearly 50% of those patients use Medicaid”) are indicators for Target 3.7.

Indicators for SDG 2 (Zero Hunger)

• Number of Nutrition Assistance Beneficiaries: The figure of “nearly 25,000 Whatcom residents use” SNAP is a direct indicator for measuring the reach of food assistance programs (Target 2.1).

Indicators for SDG 1 (No Poverty)

• Coverage of Social Protection Systems: The numbers of people covered by Medicaid and SNAP (as mentioned above) serve as indicators for the reach of social protection systems under Target 1.3. The potential reduction in these numbers indicates a negative trend.

Indicators for SDG 10 (Reduced Inequalities)

• Disproportionate Impact on Specific Services: The data showing that services for women’s health (72% Medicaid patients), in-patient mental health (56%), and children’s therapy (65%) have a higher share of Medicaid patients serves as an indicator of how cuts will deepen inequalities for these specific groups (Target 10.3).

4. Table of SDGs, Targets, and Indicators

Source: cascadiadaily.com