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Thousands of Washingtonians could soon lose Medicaid, or Apple Health, coverage: Federal pandemic-era provisions are expiring, and the state will once again require patients to renew their eligibility every year.

Starting April 1, federal Medicaid requirements will mandate for the first time in three years that states reconfirm patients’ income and household size if they want to retain coverage.

In Washington, about 300,000 people, including 100,000 in King County, will be up for plan renewal over the next year.

The renewal process usually happens every year, generally on the anniversary of Medicaid members’ enrollment date. But during the pandemic, the country’s public health emergency in part ensured those on Medicaid did not have to go through the annual renewal process to reestablish eligibility.

“A lot of people’s whole financial situation was changing dramatically during the public health emergency and with some frequency,” said Melissa Stevens, vice president of community engagement and growth at Community Health Plan of Washington, a Seattle-based health insurer.

“Not having to go through that renewal process made sure that everyone was still getting access to health care at a time that it was really critical for the whole country,” she continued.

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Nationwide, more than 91.3 million people had enrolled in Medicaid as of October 2022, nearly a 29% increase since early 2020, according to Kaiser Family Foundation.

The pandemic-era policy also helped boost enrollment in Apple Health (Washington’s name for Medicaid) and lower our state’s uninsured rate from 12.6% in May 2020, when unemployment claims surged, to 5.2% by June 2021, according to the state’s Office of Financial Management.

The Kaiser Family Foundation also estimated that starting next month, between 5 million and 14 million Americans could lose Medicaid coverage as states require people to go through the renewal process.

Some Apple Health members will be automatically reenrolled because their income and citizenship status can be confirmed through federal and state verification systems, according to a recent post from Public Health – Seattle & King County.

Still, all Apple Health members should check their accounts to make sure their contact information is updated on the Washington Healthplanfinder website and then keep an eye out for a letter or email about their renewal date. Most members will have 60 days to renew their coverage, Stevens said.

Renewal paperwork will largely focus on questions about members’ income, the number of people in their household, their ages and their Social Security number if applicable, Stevens said.

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Those who are no longer eligible for Apple Health — for example, if their income increased — can buy a Qualified Health Plan, a state-approved private health insurance plan, through Washington Healthplanfinder. Although the state’s open enrollment period ended in January, anyone who loses Apple Health coverage in the coming year will be able to apply for another plan during a 60-day special enrollment period.

There are some affordable options, including Cascade Care or Cascade Select plans that often offer monthly premiums of $10 or less with federal and state subsidies, Stevens said.

“We’re particularly concerned about people who could be eligible but might miss the opportunity to go through the renewal process because they didn’t receive the notification from the state,” she said. “Nothing’s more important than making sure they get to maintain their coverage if they’re eligible, or that they get help to transition to another plan so they have access to quality care.”

Elise Takahama: 206-464-2241 or etakahama@seattletimes.com; on Twitter: @elisetakahama.

Inflation: Efforts to lower everyday costs

The latest inflation report shows inflation eased slightly, but remained high last month.

A six-figure salary has long been a milestone for American workers. But, according to a new study, times have changed and $100,000 simply isn’t quite what it used to be in many cities.

Financial technology company SmartAsset compared the after-tax income in 76 of the largest U.S. cities and then adjusted those figures for the cost of living in each place.

Shocker: If you live in Seattle, $100,000 may not go very far.

$100K goes furthest in Memphis, Texas cities

The city of Memphis may be known for the blues, but Memphis’ low cost of living surely won’t make you sing them.

According to the survey, a $100,000 salary is worth more ($86,444) than in any other city after subtracting taxes and adjusting for the cost of living.

And $100,000 also goes a long way in Texas.

Thanks to no state income tax and the low cost of living, seven out of the 10 cities in the top 10 are located in Texas.

After deducting taxes and adjusting for the cost of living, a $100,000 salary on average is worth $77,885 across the 10 Texas cities.

Cities where 100K goes furthest

100K doesn’t go very far in New York City, California

Taxes and cost of living take a big bite out of a $100,000 income in the Big Apple, which ranks last in SmartAsset’s analysis.

After adjusting for those factors, $100,000 is worth just $35,791.

And $100,000 also doesn’t go very far in California.

Five out of the 10 cities that are ranked in the bottom 10 are located in the Golden State.

Cities where 100K doesn’t go far

This study comes as inflation continues to push the cost of living higher.

According to a recent survey, 51% of people who earned more than $100,000 reported living paycheck to paycheck in 2022 – 7% higher than a year earlier.

RELATED: Buying a home is now more affordable than renting in these 5 US cities

This story was reported in Los Angeles.

Washington hospitals lost more than $2 billion last year, but this week reached an early agreement with state lawmakers that would get them more federal dollars and help health care systems out of their growing financial hole.

In the final quarter of last year, hospitals lost another $500 million — continuing a trend of massive financial losses that has worried health care leaders for months. This week, Cassie Sauer, president and CEO of the Washington State Hospital Association, said in a news conference that the results are “clear and incredibly concerning.” A recent legislative agreement, however, could help close some short-term gaps in Medicaid reimbursements through a proposed directed payment program, known as a safety net assessment program in Washington.

“The financial losses that our hospitals are experiencing continue to be enormous,” Sauer said. “Revenues simply are not keeping up with rapidly escalating costs. It’s most concerning as these large losses are putting patient care at risk in many communities across the state.”

Of the 81 acute-care hospitals surveyed — representing 98% of the state’s beds — 69 lost money, said Eric Lewis, the association’s chief financial officer. Twelve made a profit, though 11 were rural, critical-access hospitals that received extra COVID-19 relief funding in December 2021.

Hospitals saw a 120% increase in costs for travel nurses, jumping from about $860 million in 2021 to $1.8 billion in 2022, according to the association survey results. They also reported a rise in costs for permanent employees, and for supplies, drugs and other expenses.

Lewis attributed the bulk of the losses to factors that have plagued the hospital association all year — including low Medicaid reimbursement rates for larger, urban hospitals; high inflation costs; labor shortages; and lengthy patient stays due to more complicated care.

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“Expect 2023 to also be a financially challenging year as expenses are expected to continue to rise faster than reimbursement,” Lewis said.

The hospital association is hoping for some relief from the federal government through its proposed directed payment program, which many other states already have. On Tuesday, state lawmakers reached an agreement that moves the directed payment proposal forward.

“When hospitals are not financially viable and over time sustain heavy losses, you must either increase revenue or reduce health care services,” said Chelene Whiteaker, the hospital association’s vice president of government affairs. “Reducing health care services is an option nobody wants on the table. So that leaves increasing revenues.”

Washington has long run a much smaller version of this program, but a couple years ago the federal government told state leaders it would need to be fully phased out by 2028, citing policy changes. For the past two years, the hospital association has been trying to find a new plan that would not only continue the program’s efforts to ensure Medicaid access but expand them.

“We were kind of forced to look at losing those federal funds for Medicaid or come up with a new program,” Whiteaker said.

According to Whiteaker, many Washington hospitals get 60% to 80% of their funding from government programs like Medicare and Medicaid, which haven’t kept up with the rising costs of inflation, wages and supplies.

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Hospitals need at least $1 billion annually in increased Medicaid payments to help sustain services, Whiteaker said. That large of an increase in payments would be “challenging for our state Legislature,” she said, which is why the directed payment proposal wouldn’t use money from the state general fund.

Instead of requesting state general dollars, the program would tax Washington hospitals, then get matching funds from the federal government and send that back to state hospitals that care for Medicaid patients. For every dollar the hospitals are taxed or assessed, the federal government would return $3, Whiteaker said.

The proposal would bring the state’s Medicaid rates up to nationwide Medicare rates, and rake in an additional $1 billion from federal reimbursements starting sometime next year, she said.

The bill that provides more details on the agreement is expected to be introduced to the Legislature in the next couple of days.

If the state Legislature approves the program, the hospital association must then seek federal approval from the Centers for Medicare and Medicaid Services through the state’s Health Care Authority.

“Our state has been very generous in expanding coverage to people on Medicaid, but has not matched that with [hospital reimbursement rates],” Sauer said. “This is a real investment in making sure that that’s the case.”

Elise Takahama: 206-464-2241 or etakahama@seattletimes.com; on Twitter: @elisetakahama.

The Seattle Times’ Project Homeless is funded by BECU, Campion Foundation, Raikes Foundation, Seattle Foundation and the University of Washington. The Seattle Times maintains editorial control over Project Homeless content.

OLYMPIA — Charles Adkins remembers when he was asked to pay $700 to stay at the dorms at The Evergreen State College during his freshman year. He panicked because he didn’t know where he’d be able to stay since he couldn’t afford it.

He was still wearing the clothes he received from the youth homeless shelter he lived in before and didn’t have a laptop.

“I was so stressed. I was failing college [worrying about] not having money to pay rent,” Adkins said.

As a student lobbyist in 2018, Adkins worked to create a bill to support students experiencing homelessness and students that have aged out of the foster care system.

It took a few years, but now that idea could become permanent. State Sen. Yasmin Trudeau, D-Tacoma, is sponsoring Senate Bill 5702, which allows public institutions like community and technical colleges and four-year institutions to create their own plan to address the needs of their students from housing to food insecurity, because data from a pilot program, launched in 2019, shows how successful it is in supporting basic needs and allowing students to finish their programs.

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The bill passed the Senate on March 2 on a 46-3 vote and is in the House for consideration.

Sen. Keith Wagoner, R-Sedro-Woolley, said he opposed it because he doesn’t want to leave taxpayers on the hook for funding the program in perpetuity.

“I hope the funding issue will be addressed in the House or if the bill is returned to the Senate,” Wagoner said.

A survey in January revealed that almost half of Washington college students have experienced food or housing insecurity in the last year, and it was more common at two-year colleges.

Those experiencing housing insecurity said they were unable to pay rent or utility bills. They also reported sleeping at friends’ or relatives’ places, in cars, outside, or in shelters.

“There are so many assumptions that are made about people going to college, assuming you have a family supporting you,” Adkins said.

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Adkins became homeless at age 15 after a fight with his father. Throughout high school, he lived on the streets or couch surfed before he ended up in a homeless youth center in Everett.

Adkins said he received more homelessness support during his K-12 educational career, including a case manager. Many Washington high school students don’t have that.

Washington leads the country in identifying homeless students, but received the least amount of federal funding earmarked to support them in the 2018-19 school year.

K-12 student homelessness is linked to lower graduation rates, higher rates of suspension or expulsion, and homelessness as an adult.

And many college students get even less support.

State Rep. Lillian Ortiz-Self, D-Mukilteo, who was Adkins’ high school counselor, revived his bill in 2019, creating the Supporting Students Experiencing Homelessness pilot program.

The program has doubled from its initial figure of two community technical colleges and two four-year institutions and colleges. These colleges are from different parts of the state. Colleges received from $93,000 to $108,000 or more in funding, with extra added in the 2021 legislative session.

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The Washington Student Achievement Council reported that over three years, 2,500 students experiencing homelessness or who aged out of the foster care system were served by the program. More than 90% of students at four-year institutions and 85% of students at two-year institutions completed the quarter in which they received help from Supporting Students Experiencing Homelessness.

“The intent of the pilot was to understand the need, promising strategies and persistence of students who were served,” said Ami Magisos, associate director for policy and planning at the Washington Student Achievement Council. “Now that we have three years’ worth of data, there is a high number of students eligible and served and have the persistence.”

Magisos said they measure persistence from when the student initially sought support to when they finished their program.

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Several states, including California, Louisiana and Tennessee, require postsecondary institutions to place students experiencing homelessness in housing. These states, along with Maine, also require institutions to prioritize these students for housing registration and to create housing plans for them.

Kelly Green, vice president of advancement at South Puget Sound Community College, said the college applied for the pilot program due to student needs.

She said the institution had funds to provide resources like showers or laundry facilities and a food pantry, but it needed funding to provide short- and long-term housing.

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A South Puget Sound student experiencing homelessness will go through a “personal support center,” which brings academic and social services together, and be referred to the Supporting Students Experiencing Homelessness program. The college pays for three-month leases by partnering with apartment complexes near campus. This can be extended if the student’s personal case management plan is not working.

Green said a majority of the grant given to South Puget Sound goes to the leases. The program also has community partnerships to be able to assist students with other needs outside of basic necessities.

Mariela Barriga Chavez, director of Student Success at Highline College, said when the pilot program came out, school officials felt that the state was recognizing all students.

Highline makes students take a survey when they first enroll and asks “getting-to-know-you” questions, one of which is about a student’s housing. Depending on the answer, a student is directed to options like the Supporting Students Experiencing Homelessness program.

From there, students work with a full-time case manager who creates a plan for the college to pay for housing near campus. Students are also provided Chromebooks.

“What we are looking for is to allow students to continue their studies and for them to know that the college does not just want them to pass their classes,” Chavez said.

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She said that this support is mostly for one quarter, usually from 30 to 60 days or until they have leased an apartment. Chavez also said that every student who has been supported by the program finished the academic quarter in which they received support.

Sponsor Trudeau said she experienced this herself. She went through the foster care system and lived in 11 homes before graduating from high school. When she went to college, she had anxiety during school breaks since she had nowhere to stay.

She didn’t receive guidance or support from her institution and did not finish her initial academic plan, she said, having to transfer and eventually stop school to support her family.

“I think a lot of people when they think about homelessness, they think about tents on sidewalks and not housing insecurity,” Trudeau said. “I didn’t know until years later that couch surfing was actually being homeless. Like, what do you mean? I was homeless? You had no home.”

Jadenne Radoc Cabahug: 206-464-8275 or jcabahug@seattletimes.com; on Twitter: @jadennecabahug. Jadenne Radoc Cabahug is a staff reporter for The Seattle Times.

Seattle could see its first 60-degree day of the year this week on Friday and Saturday.

Credit: kieferpix - stock.adobe.com

SEATTLE — What has felt like a long, cold, snowy winter appears to finally be coming to an end, at least temporarily, later this week.

Transitioning from winter to spring

Not only are temperatures forecast to warm later this week into the first half of the weekend but the sunsets are now later than 7 p.m. and we are gaining more than three minutes of daylight each day.

The longer days, paired with the higher sun angle as we move toward spring, along with an area of high pressure building overhead, flipping the winds offshore will cause a spike in warmth on Friday and Saturday.

Upcoming weather pattern

Credit: KING 5

Upcoming weather pattern

High-temperature forecast

Temperatures could hit 60 degrees Friday and Saturday putting an end to the long stretch of below-average temperature days that have accumulated since the beginning of the year. The current forecast in Seattle calls for a high temperature of 60 degrees for both days under mostly sunny skies.

While these temperatures are warmer than the average high of 54 degrees, they'll be far from record territory. Friday's daily record high is 71 set back in 1947 and Saturday's daily record high is 76 set in 2019.

Seattle high-temperature forecast

Credit: KING 5

Seattle high temperature forecast

Not only does Seattle have a chance to achieve 60 degrees on Friday and Saturday but other parts of western Washington will see temperatures climb into the upper 50s and lower 60s.

Western Washington high-temperature forecast Friday

Credit: KING 5

Western Washington high temperature forecast Friday

Western Washington high-temperature forecast Saturday

Credit: KING 5

Western Washington high temperature forecast Saturday

If Seattle achieves 60 degrees, it would mark the warmest day of the year thus far. The warmest temperatures of 2023 at Sea-Tac were recorded back on Jan. 5 and Jan 14 when it climbed to 59 degrees. So far the warmest temperature in March was 52 degrees on March 11.

Seattle normally records its first 60-degree or warmer day on Feb. 22.

The spring equinox is next Monday at 2:24 p.m.