Washington Is Slashing Medicaid — Here’s What That Means for Your Parent’s Care
Jul 10, 2025
Medicaid changes are coming to Washington State in 2025—and they could have a serious impact on families caring for aging loved ones. Whether you're in Seattle, Tacoma, Everett, or anywhere in between, these changes could affect how you access in-home care, what services are covered, and how long you wait for help.
This isn’t just political noise. It’s a real shift in how long-term care will be funded and delivered. This guide will walk you through what’s changing, who will be affected, what services could be at risk, and what alternatives exist.
What’s Changing with Medicaid in Washington?
In 2025, proposed state budget cuts are expected to tighten eligibility for Medicaid-funded long-term services and supports (LTSS). These state-level changes are directly tied to the sweeping federal “One Big Beautiful Bill Act,” signed into law July 4, 2025.
Nationwide Medicaid cuts total about $1 trillion over the next decade under the federal bill.
The proposed state budget cuts are expected to tighten eligibility for Medicaid-funded long-term services and supports (LTSS). According to the Washington State Department of Social and Health Services (DSHS), the cuts are likely to affect:
The number of hours authorized for in-home support
The types of services approved
Wait times for assessment and enrollment
A recent article from The Seattle Times reported that reductions in LTSS funding could result in staffing challenges and lengthier delays for assessments and care coordination. As quoted in the piece: “The state is bracing for longer waitlists and reduced service availability as funding shrinks and demand grows.” Services like Carina which provides home care for those on Medicaid in the state will be affected as well.
Who’s Most Affected?
These cuts won’t be felt equally. The groups likely to experience the most disruption include:
Low-income seniors who currently depend on Medicaid for basic in-home assistance.
Middle-income families trying to qualify for Medicaid but falling through the cracks due to asset limits.
Older adults recovering from hospital stays or surgery, who need temporary in-home help.
Real-World Example: After her stroke, 78-year-old Mary from Tacoma was approved for 12 hours per week of in-home care. Under the 2025 guidelines, she may be reassessed and could lose half of those hours, placing pressure on her daughter to fill the gap.
Common Use Cases:
Caring for an aging parent recovering from surgery
A spouse balancing work while providing home care
Seniors needing support with bathing, dressing, or meal prep
What Services Could Be Lost or Delayed?
Here’s a look at the services currently covered by Medicaid that may be reduced, delayed, or eliminated:
Waitlists are also expected to grow as caseworkers are overwhelmed. For families trying to set up care quickly after a hospital discharge, this can mean weeks of delay—or no care at all.
How Can Washington Families Prepare?
Preparation is key. Don’t wait until you’re in crisis. Consider these proactive steps:
1. Start Planning Early
Even if you’re not using Medicaid today, start exploring your options. Understand your loved one’s needs and financial position.
2. Know the Alternatives
If Medicaid becomes harder to access, these are your next best options:
Long-Term Care Insurance: If already in place, review what it covers.
Out-of-Pocket: This ranges widely. Basic help may cost $3,000/month; 24/7 care can exceed $10,000.
Private-Pay Models: Some agencies offer flexible, local, no-contract services.
Example: Some home care providers in Seattle and Bellevue offer “all-inclusive” private-pay care at a predictable monthly cost, giving families more control.
3. Understand the Model (Without the Hard Sell)
All-inclusive, private-pay home care means:
One monthly rate
No hidden fees
No government approval or waitlists
Faster access to caregivers
This model works especially well for families who don’t qualify for Medicaid but can’t afford $8,000/month assisted living.
When Private-Pay Home Care Makes Sense
If you’re caught in the middle—earning too much for Medicaid, but not enough to handle assisted living entrance fees ($300,000+ at some communities)—private-pay care may be the best fit.
Private-Pay Pros:
Immediate care — skip waitlists
Stay at home — avoid moving to a facility
Scalable — start with light help and increase if needed
Affordable spectrum — e.g. $3,200/month vs. $7,500+ assisted living
Caringene helps families in King, Pierce, and Snohomish County access all-inclusive care with no contracts, upfront fees, or delays.
📍 To learn more about our home care services visit our home page or contact us to get help now.
Resources for Families
Also consider speaking with:
Elder Law Attorneys (Medicaid planning)
Senior Care Consultants (Placement & planning)
Estate Planners (For long-term asset protection)
Conclusion
Medicaid cuts in Washington are no longer just speculation. The impact is coming, and families who depend on this system could be left scrambling for help.
But there are ways to stay ahead. Whether it’s preparing early, reviewing your options, or exploring flexible home care models like Caringene, the key is not waiting until it’s urgent.