Medicaid cuts threaten coverage for Spokane refugees

Several thousand documented refugees in Spokane County could lose Medicaid starting Thursday. The local International Rescue Committee says those at risk span three major groups. One is 200 refugees with serious medical needs. Another is 1,000 people awaiting decisions on green cards. More than 2,500 Ukrainians admitted through Uniting for Ukraine may also be affected. The shift comes from H.R. 1, enacted on July 4, 2025, which restricts Medicaid for certain immigrants who lack permanent residency.

The rules affect refugees, people granted asylum, humanitarian parolees, trafficking or domestic-violence survivors, and some immigrants with complex health needs. Green card holders remain eligible for federally funded Medicaid. Emergency coverage, immigrant children, pregnant people and certain national groups are among the exceptions. State agencies estimate 10,000 to 12,000 Washington residents could lose insurance, with 60% living beyond King County.

More federal changes begin Jan. 1. Some people moving from Medicaid to Marketplace plans will lose access to federal premium assistance. In 2027, those credits become limited to green card holders and exempt groups. Other Medicaid recipients will face six-month eligibility reviews and must document 80 monthly hours across employment, schooling or service. Spokane nonprofits are explaining the rules, increasing food support and connecting clients with state health programs. They see congregations as trusted places for sharing information, raising money for premiums and hosting service opportunities.