JFS Clients Lose Access to Health Care

Today, 11,000 Washingtonians are losing their health insurance because of H.R. 1 (aka the Republicans’ “One Big Beautiful Bill Act”) that was passed in July 2025. These immigrants (refugees, asylum seekers, and other immigrants) are in the country legally, and many depend on Medicaid for life-saving care. It’s hard to visualize 11,000 people. Below are two stories from JFS clients whose lives depend on Medicaid and yet they are losing coverage. These are just two stories, but many members of our community are reeling from this loss.

Sasha’s story

Sasha (name changed for privacy) is a Jewish refugee from the former Soviet Union in his 70’s and has been a client in our Supportive Living Services program for more than 20 years. He is losing his Medicaid today. Sasha is housebound and needs significant support for his daily activities. Due to physical limitations, Sasha cannot cook a meal or even heat one in the microwave. As a refugee, Sasha needs to apply for a green card but because of his physical and mental health challenges, he has not been able to follow-through on what is an intensely high-barrier process—even for people who are healthy.

Losing Medicaid means Sasha is losing his Community Options Program Entry System (COPES) funding from Medicaid, a program that pays for services to help people who would otherwise need to live in a nursing home. COPES pays for more than 160 hours of home care a month for Sasha, which he desperately needs. His home care aides assist him with cooking and serving meals, laundry, bathing, grocery shopping, picking up prescriptions, other household tasks, and companionship.

Sasha’s JFS Case Manager has been working diligently to put a plan in place to support him, although nothing we provide will be able to replace the government support that Sasha is losing.

• JFS will pay for some home care with the same aides who know him well – thanks to funding from Seattle Association of Jews with Disabilities (SAJD) Foundation Board. However, this is a significant reduction in services for Sasha.
• Our in-home team will increase their visits from one hour to six hours a week, making sure to visit Monday through Friday afternoons. We will do his grocery shopping, help him get fed a meal every shift, clean up, and offer companionship.
• We are also working on getting Sasha meals delivered by Chicken Soup Brigade—up to 14 free healthy meals per week. These will need to be heated up by his aides or JFS staff but will help fill the gaps for meals since his home care aides will have less time for cooking. We will supplement any food needs Sasha has from our food bank.

JFS staff are also working with Sasha’s primary care provider to apply for sliding scale services and to centralize records and prescriptions from other providers.

As you might imagine, Sasha is very distressed and worried—as are his amazing home care aides who have cared for him so beautifully for many years. While our wonderful SLS team is doing what we can to fill the gaps, it feels woefully inadequate.

We anticipate that Sasha’s health will decline and that this might precipitate a health crisis. If his needs significantly increase, it’s possible Sasha could qualify for a new state program that was created to fill the hole that the federal administration has created.

Maryam’s story

Maryam (name changed for privacy) is a single mother from Somalia who was resettled by JFS in Seattle in January 2024 with her six children, the eldest of whom turned 18 years old shortly before arrival. Her youngest child has a congenital heart condition and underwent surgery a few months after arriving in the United States. She is now much stronger but continues to have multiple medical appointments every month.

Unfortunately, Maryam was diagnosed with cancer and began her first round of chemotherapy in July 2024. Maryam also suffers from acute post-traumatic stress disorder (PTSD) and has shrapnel in her head from a gunshot wound that was untreated for many years. She is unable to leave home on her own. Her eldest daughter is a paid caregiver for her mother because of Maryam’s medical fragility.

The family applied for legal permanent residency after becoming eligible to do so in early 2025. They received a notice from U.S. Citizenship and Immigration Services that their application was received but have not been contacted further about the status of their application. This summer, Maryam began another round of chemotherapy. She has been approved for Social Security Income (SSI), but as of today she is losing her Medicaid coverage.

Since this loss of coverage is happening during her prescribed sessions of chemotherapy, our JFS intensive case management team has been working with her cancer team to help Maryam access Alien Emergency Medical (AEM) which would ensure her medical treatment can continue. She has applied for it and should qualify for AEM.

However, even if it’s approved, it will not cover a paid caregiver. Because of this, Maryam’s now 20-year-old eldest daughter, who attends high school full time and ensures her mother and siblings attend all of their necessary doctor appointments, will need to look for work outside the home. Maryam’s eldest son will miss his last football season and find employment as well because Maryam’s monthly SSI payment does not cover the rent.

Unfortunately, the health care authority rejected Maryam’s AEM application because she had Medicaid coverage at that point. Now she will have to reapply and wait for review.

Work requirements on their way

More changes to Medicaid are on their way thanks to H.R. 1. Starting January 1, 2027, burdensome work requirements will go into effect for the first time, affecting more than 600,000 Washingtonians. They will also be required to reapply for Medicaid twice as frequently. The work requirements mean that people must work or participate in community service for at least 80 hours a month or be enrolled in an educational program at least half of the time. A recent study in JAMA Health Forum found that 1 in 5 enrollees may lose their health coverage because they are unable to get enough work hours. That means 2 million people nationwide are employed but still won’t be able to meet the work requirements.

This will impact more of our neighbors, family, and friends who rely on Medicaid.

We take care of each other

When government support falls short and our safety net snaps, JFS and our community step up to support our neighbors as much as we can. Whether people need food, financial assistance to prevent eviction, help finding safety, or building a new life, we are here to provide a helping hand. But the truth is that JFS cannot replace support that has historically been provided by the federal government, and people like Sasha and Maryam and her family are the ones who bear the brunt of these policies.

Our clients face immense obstacles that can make hope feel out of reach at times. We honor them by walking alongside them with compassion, providing dignified care, advocating for their needs, and never losing sight of the possibility of a better future. In doing so, we are reminded every day of the resilience, humanity, and strength of our entire community.

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Learn more about our Refugee and Immigrant Services and Supportive Living Services.