Nonprofit leaders called on Spokane’s faith community and others during a Sept. 25 informational meeting at the CHAS Health Learning Institute to help refugees navigate changes that could leave several thousand Spokane County refugees without health care coverage.
“We can’t do it alone,” wrote Kimmie Curry, the community engagement manager for the International Rescue Committee (IRC) in Spokane, in the meeting’s email invite. IRC in Spokane, Better Health Together, CHAS Health and Spokane Workforce Council convened the informational meeting to help faith and other community leaders understand the changes and how they can connect affected refugees with resources.
Beginning Oct. 1, the IRC in Spokane estimates that the refugees in Spokane County who are at risk of losing Medicaid include 200 medically fragile refugees, 1,000 refugees with pending green card applications and more than 2,500 Ukrainian refugees who arrived in Spokane through the Uniting for Ukraine (U4U).
The changes stem from H.R. 1, which was signed into federal law July 4, 2025, and alters Medicaid eligibility and other federal benefits for some documented immigrants and refugees who do not have permanent resident status.
The new law will no longer provide Medicaid to refugees, asylees, humanitarian parolees (including Ukrainian and Afghan evacuees), survivors of trafficking or domestic violence and medically fragile immigrants, despite being documented.
Instead, lawful permanent residents (LPRs), commonly referred to as green card holders, will qualify for federal Medicaid funding.
‘It’s insane’
Karen Stromgren leads Muslims for Community Action and Support as its executive director and was one of the faith leaders who attended the informational meeting. She said learning about these changes left her with the impression that the U.S. government no longer cared for refugees and immigrants.
“It’s insane,” Stromgren said. “I can’t even imagine people, especially those that are disabled or medically fragile, losing their coverage. I mean, that is just absolutely devastating.”
Washington’s Health Care Authority and the Department of Social and Health Services estimate that about 10,000 to 12,000 documented immigrants and refugees in Washington could lose coverage — 60% of whom live outside King County — because they don’t have a permanent resident status or a green card.
Some exceptions include noncitizens in need of Emergency Medicaid coverage, immigrant children and pregnant people and immigrants from Cuba, Haiti and Compacts of Free Association nations.
Getting the word out
Because of these changes, the challenge is educating not only individuals who work directly or indirectly with refugees, but also the refugees themselves.
“We are spending time helping (refugees and immigrants) understand what the exact impact will be to them, and it’s shocking,” said Margaret Hinson, IRC in Spokane’s director. “People do not understand what is coming.”
Kevin Williams, the CEO of Spokane Workforce Council, told the attendees these changes will cause more people to fall through administrative cracks.
“Who falls into cracks? People who don’t know where cracks are, and this is a huge crack that people can fall into if they don’t know it’s right in front of them,” Williams said.
The meeting’s organizers are already educating clients about new requirements, expanding food assistance and helping people maintain medical benefits through state-run programs. They said key concerns include confusion about the changes, increased health care demand and the risk of losing coverage or subsidies.
More changes coming
The changes won’t end in October.
Attendees also learned that additional changes to federal health care benefits are scheduled to take effect Jan. 1, 2027.
First, some noncitizens who lose Medicaid eligibility and turn to private Marketplace insurance will no longer qualify for federal premium tax credits. Beginning in 2027, those credits will be limited to lawful permanent residents and those who fit the exemption criteria.
Second, some immigrants who remain eligible for Medicaid will be subject to a new requirement to report 80 hours a month of work, education or community service or a combination of those activities. Eligibility will also be shortened to six months instead of a year.
Williams said experiences in states that implemented Medicaid work requirements early show that more than half of some affected populations lost their benefits. He said this occurred not because the clients weren’t willing to track hours but because they were unaware of what steps they needed to take or didn’t realize which activities counted toward their required hours.
A March Urban Institute research report projects that the combination of six-month redeterminations and work requirements could reduce enrollment between 27% and 55% in 2028 among people subject to the work requirements, depending on how states implement and mitigate the policies.
What faith communities can do
Williams sees faith communities as well-positioned to help mitigate those losses because they are trusted institutions. Refugees and immigrants may be more likely to turn to faith communities for help navigating the changes than to government agencies, he said.
Faith-based organizations can take the opportunity to hand out information to those affected and “be a voice to say, ‘Hey, did you know this is happening?’” he said, adding that they could also point refugees to nonprofit organizations like his and those leading the informational meeting to get the assistance they need.
Other event organizers suggested the faith community could help refugees by putting on fundraisers to help offset health care premium costs. They could also use their worship spaces as culturally sensitive locations for refugees to participate in qualifying community-service hours.
“At IRC, we work with our faith-based partners extensively and genuinely couldn’t do what we do without their support,” Curry said.
She also suggested faith-based communities could help increase social safety nets and resources at organizations like IRC Spokane, Manzanita House, World Relief and others.
Hinson, of IRC Spokane, suggested faith communities could also use their “very powerful voice” to encourage legislators to “right this ship” on local and state levels so refugees can continue thriving.
Stromgren believes all these suggestions are examples of neighbors helping neighbors, no matter their country of origin.
“We are supposed to be able to take care of one another. That’s one of the pillars in our religion (Islam),” Stromgren said. “You start with your neighbor and your family, and onward.”