As immigrant Medicaid cuts take effect, some in WA can keep their coverage

Roughly 10,000 immigrants in Washington are losing their Medicaid health coverage due to federal cuts Republicans in Congress approved last year.

On Thursday, a provision in President Donald Trump's signature tax cut and spending law stripped Medicaid coverage for refugees, asylees and other lawfully present immigrants, including people who fled the war in Ukraine and trafficking victims, for example. Some of them have disabilities and receive long-term care.

Advocates say this will lead to many of these individuals getting sicker and putting themselves in danger of dying earlier than they would if they had health insurance. This will further strain hospitals as these patients will fill emergency rooms for treatment.

"Most of them cannot possibly afford to buy insurance on their own, so will be left with no coverage at all, no access to primary care doctors, no access to prescription drugs, no access to the care that they need," Service Employees International Union 775 Secretary-Treasurer Adam Glickman told reporters Thursday.

A federal judge in Seattle on Wednesday provided a temporary reprieve for a segment of those immigrants, saying those who receive Supplemental Security Income, or SSI, are still eligible for Medicaid, despite rules from federal officials trying to flout this longstanding precedent.

The ruling from U.S. District Court Judge Thomas Zilly allows an estimated 800 migrants to keep their coverage for the time being. The feds can appeal the preliminary order.

Lee Che Leong, senior policy advocate with Northwest Health Law Advocates, called Zilly's decision a "crucial victory."

Roughly 3,000 other lawfully present immigrants would have lost their coverage if not for efforts by state officials who updated their immigration information to enable them to keep their Apple Health, the state's low-income insurance program. Initial projections showed 14,000 noncitizens losing coverage.

The federal law maintains coverage for lawful permanent residents with green cards and other select categories of migrants.

Come January, it will knock tens of thousands more Washingtonians off Apple Health when new strict work requirements take effect.

Over 1.9 million residents in Washington are enrolled in Apple Health.

Of those, at least 200,000 are projected to be stripped of coverage by the end of 2027 as a result of the Republican-backed law, according to state officials.

Critics of the law fear thousands will lose their healthcare despite meeting the new work requirements because of what they see as cumbersome paperwork barriers to maintaining Medicaid. The state is spending millions of dollars on IT services to verify enrollees meet the forthcoming requirements.

'Conditions will get worse'

Of the thousands being kicked off Medicaid on Thursday, two in five live in King County, according to county Councilmember Teresa Mosqueda. She argued the cuts will mean less financial reimbursements for healthcare systems. The effects of this will trickle down to patients with insurance, some of whom could wind up paying higher premiums to make up the difference.

"People will be laid off in clinics and hospitals around our county and state," Mosqueda said in a press conference. "Wait times will soar and care will be delayed. Conditions will get worse and more people will die."

Gov. Bob Ferguson, a Democrat, last month signed an executive order aimed at finding ways to keep Washingtonians insured. It set up a committee of state officials to develop strategies and identify state actions that will help people maintain their coverage. The order also directs a statewide public awareness campaign to let enrollees know about the cuts, and the creation of a database to track coverage losses.

Glickman and other advocates are calling on Ferguson and state lawmakers to fill the gap with state funding so these migrants can regain healthcare. Some are pushing for tax increases to pay for it.

Mosqueda said King County should follow Los Angeles County, which is implementing a new sales tax hike to raise $1 billion per year in response to the Medicaid cuts.

Washington is one of a number of states that provide Medicaid to residents who don't qualify for the federal program due to immigration status, but capacity is limited. The option is fully state funded. Immigrants without legal status are ineligible for federally funded health insurance.

"While some people may qualify for other Apple Health programs or coverage through Washington Healthplanfinder, understanding those options now is critical to avoiding gaps in care," said Leanne Berge, the CEO of Community Health Plan of Washington.

The Legislature earmarked nearly $20 million to ensure immigrants here could retain long-term care insurance coverage despite the federal cuts, but the money isn't expected to go nearly as far as lawmakers expected. Though this week's court ruling could allow that state funding to cover more enrollees.

Immigrants who remain eligible must be lawful permanent residents, Compact of Free Association islanders or Cuban or Haitian.

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