Proposed Medicaid cuts could seriously affect Washington hospitals and health care workers.

President Donald Trump and House Republicans are proposing $800 billion in cuts. Critics said it could mean ending health care access for nearly 2 million people on Washington's Apple Health, and about 73 million Americans nationwide.

Justin Gill, a nurse practitioner and president of the Washington State Nurses Association, said at least one in three patients he sees are on Medicaid. Many have been able to get medical care for the first time in years because of the program and Gill said cuts would be devastating.

"That's going to directly impact their ability to access care when they need it," Gill pointed out. "That has long-term effects on their ability to catch conditions early, before they become much more costly and much more debilitating."

In Washington state, the federal government pays 50% of the cost of traditional Medicaid, and 90% of costs for people covered under the Medicaid expansion, which extended coverage to nearly all low-income adults. Medicaid also currently covers one-third of births in the state and care for the majority of nursing home residents.

Critics of Medicaid said it is a drain on the federal budget. But proponents countered the government benefits in many ways from having a healthier population. Gill noted Medicaid cuts would limit patients' access to necessary tests and other diagnostics, which also increases the stress and risk for their providers.

"Nurses and physicians are going to be expected to still be held to a high standard, provide a high level of quality of care, and then have the resources taken out under us as the system collapses," Gill contended.

Health care workers are often advised to stay out of politics, Gill acknowledged, but the issue goes beyond party lines.

"We're going to call out policies that are going to hurt our patients, just like we would speak up for them at the bedside," Gill emphasized.


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As Women's Health Month winds down, experts in alcohol abuse are speaking out about an increase in binge drinking among women over the past five years.

A recent study from the Journal of the American Medical Association found that women are now binge drinking more than men for the first time in history.

Joanne Hawes - director of clinical operations with the Betty Ford Center in Rancho Mirage, California - explained that women's bodies make them more vulnerable to excessive alcohol consumption.

"Alcohol is actually ingested differently for women, and can affect them more quickly," said Hawes. "So women tend to have health issues more quickly than men. Things like liver damage or brain atrophies, even heart disease."

Alcoholics Anonymous says 38% of their clients are women, and the proportion has been rising in recent years.

Data from the National Institutes of Health show that nearly one in three young women aged 18 to 25 binge drink on a regular basis.

Hawes added that the stress of holding down a job and caring for children during the COVID lockdown contributed to a rise in alcohol abuse among women.

Dr. Lisa Saul, chief medical officer for women's health at UnitedHealthcare, said heavy drinking among women has surged by 41% since the pandemic, heightening the risk of cancer.

"Alcohol is a carcinogen," said Saul, "and we know that it is linked to at least six types of cancer, including breast and colorectal cancer."

Many employee assistance programs offer help to find treatment. The National Institutes of Health lists alcohol addiction resources on its website, Rethinking Drinking.

Florida's new law banning fluoride in public water systems has drawn sharp criticism from dental professionals, who cite decades of evidence supporting its safety and effectiveness in preventing tooth decay.

Dr. Jeff Ottley, president of the Florida Dental Association, warned that the change will lead to a rise in cavities, particularly among children and underserved populations.

"Over the next two to three years, we will see an increase in the number of cavities, particularly in children and older adults who take multiple medications, which cause dry mouth," he said. "Those older adults will start getting cavities along the roof surfaces of their teeth and under existing restorations, like crowns and fillings."

Backers of the ban, including libertarian groups and some GOP legislators, have argued that "fluoride is a choice" and have recommended topical treatments, such as toothpaste, over what they claimed to be "mass medication."

Ottley stressed that fluoride occurs naturally in water, and the ban eliminates adjustments that allow cities to reach optimal levels for dental health.

He also predicted severe consequences, especially for Florida's Medicaid system and rural communities.

"The Medicaid system in Florida already has the lowest reimbursement rate across the country," he said, "and so you're going to have an influx in the number of kids looking, and parents looking to treat their kids who are on Medicaid, and the providers just aren't going to be there."

Ottley warned that higher Medicaid payments will be needed to attract dental-care providers, which he said could lead to ballooning costs.

His interim advice for parents: Seek prescription fluoride vitamins, and everyone should maintain rigorous brushing and flossing routines, cut their sugar intake and avoid post-brushing snacks before bed.


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California lawmakers are considering a bill to ease regulations on birth centers at a time when maternity wards are closing in many counties. Assembly Bill 55 would streamline the licensure process, which allows a birth center to accept Medi-Cal, making midwifery care available to low-income families.

Sandra Poole, health policy advocate with the Western Center on Law and Poverty, said the bill would also no longer require a birthing center to be within 30 minutes of a hospital but instead rely on a transfer plan to address potential emergencies.

"Of course, if you're in an area where the labor and delivery has closed, that's going to be impossible," she explained. "There are 12 counties in the State of California that have absolutely no labor and delivery wards at all in the county."

Birth centers are non-hospital, homelike facilities for low-risk pregnancies. At least 40% of California's birth centers have closed since 2020, and just four of the 37 remaining centers are licensed, because the current licensing process is unnecessarily burdensome, according to a study published today by the Western Center on Law and Poverty, in partnership with the California Black Women's Health Project and the Black Women for Wellness Action Project.

The study also surveyed patients on the merits of birth centers. Holly Drayton is a mother and former doula from the Santa Barbara area.

"For people to have that option would really give them the opportunity to choose the birth that they want in an environment where they do feel comfortable to labor in the way that they're supported, to make it the best possible outcome," Drayton said.

Sarah Archer, a mother who supports birth centers, said they are an important part of the state's health care system, and are proved to reduce pre-term births.

"People deserve choices in the way they want to give birth, not just in a sterile hospital," she explained. "It's a very safe, very quiet, beautiful, serene environment versus a medical setting."

The bill has passed the State Assembly and is now before the Senate Health Committee.