Submitted by Byron Hayes.

Lopez Island’s current and only clinical services provider, UW Medicine Primary Care, recently announced in late June that it will not renew its contract with the Lopez Island Hospital District and will be leaving the island at the end of June 2026. UW stated that their decision was based on state and federal funding uncertainty, combined with the significant loss they incur each year operating its clinic located in Lopez Village.

Since UW Medicine’s announcement, LIHD has hired a consultant familiar with rural health needs, funding and contracts, and is actively seeking an alternative clinical services provider. Simultaneously, LIHD is actively exploring the affordable scope of the clinical services that could be independently provided if a replacement provider is not found.

Lopez Island’s search comes at a difficult time since the changes to Medicaid eligibility in Congress, recently approved in the “One Big Beautiful Bill Act,” are bringing significant uncertainty as to the number of uninsured and its impact on health care economics nationally. Although many of the Medicaid changes will not come into effect until after the 2026 elections, many alternate providers now have significant uncertainties regarding future income and costs for their own existing operations, let alone for adding a new facility.

Compounding this Medicaid-driven hesitancy, the upcoming December 2025 expiration of tax credits for private insurance obtained through the Affordable Care Act (“Obamacare”) is anticipated by Johns Hopkins Bloomberg School of Public Health to generate an average 75% increase in premium costs for those who enroll for 2026 coverage. The effects that these heightened ACA premium costs will have on the number of uninsured Americans will not begin to be meaningfully understood until well after the upcoming 2026 enrollment period, which runs from Nov. 1 to Dec. 15, 2025.

For UW Medicine, its announced exit from Lopez could be reasonably expected based on the university’s overall financial situation. First, the Lopez clinic is the only UW Primary Care clinic outside of King County, and UW Medicine has disclosed that the clinic is running at a loss. Although the University of Washington has not been specifically targeted by the Trump administration like Columbia and Harvard, it has still encountered a current $280 million cut in federal research support, which has already resulted in close to 200 layoffs. The state, with its own fiscal issues, has also reduced its overall funding of UW by 6.5%. These overall cuts to the university, combined with the uncertainties surrounding health care, have generally resulted in an overall 2025-2026 UW Medicine budget reduction of $467 million, which is an over 7% drop from its 2024-2025 levels.

Based on both LIHD and the consultant’s timing for organizing a smooth transition, a new Lopez clinical services provider needs to be contracted in November of this year and begin its transition planning with UW Primary Care in January, with an independent operation ideally following a similar timeline. The feasibility of successful adherence to this timeline will be better understood once initial responses to the Request for Proposals are received and able to be evaluated near the end of September.

People with an interest can find ongoing general information about this transition through the LIHD website located at https://lopezislandhd.org, with current clinic transition specifics found within the board meeting documents for its 2025 Special Meetings.