Wash. — More than 11,000 Washington state residents are losing access to healthcare and food benefits today due to changes under the federal law known as H.R. 1, also known as the One Big Beautiful Act.
Those losing coverage under Apple Health, the state’s Medicaid program, include certain refugees, asylum seekers, as well as immigrants with legal status, survivors of domestic violence and human trafficking, members of federally recognized tribes, and others who are legally living in the United States through various immigration pathways.
Dr. Tara Lawal is the executive director of the Rainier Valley Midwives birth clinic, where she helps families with medical care before and after pregnancy.
Her patients include Marhelese refugees, people living in the United States from the Marshal Islands, where the U.S. tested nuclear weapons for years. She says she tried to help her patients get several months’ worth of medicine leading up to this day, but knows many of her patients will ration their medications and skip doses to make it last.
“All the things that we’ve worked so hard on, their blood pressure, their diabetes management, it just goes out the window because they’re trying to save everything.” Lawal said, “So now, they’re using emergency rooms as their primary care to go get their blood pressure medications. That’s the most expensive way for us to take care of our citizens.”
The law, signed by President Donald Trump on July 4, 2025, includes $1.3 trillion in nationwide cuts to healthcare and food assistance programs. While SNAP benefits will temporarily increase slightly, stricter eligibility requirements are expected to take effect later.
Liliana Chernova’s daughter lost her healthcare coverage, as her daughter’s kind of bone cancer did not meet the law’s stated exemption.
“She cannot get the medication that she used to take, the medications that were prescribed,” Chernova said.
Chernova and her family escaped Ukraine when Russia’s invasion of the country started a war. She works three jobs, including in a clinic and cleaning houses in Battleground, WA. Chernova had connections in Washington, so she qualified for the “Uniting for Ukraine” program that guaranteed access to healthcare as people established jobs. Chernova’s daughter, however, learned about her cancer diagnosis during her entry exam into the United States.
“It’s Congress that invited us to the USA as refugees; they now voted to deprive us of this help,” Chernova said, “Help that was really needed by my mother-in-law and is now needed by daughter.”
Chernova’s mother-in-law received a terminal diagnosis upon arriving in the U.S. Medicaid paid for some of her hospice care and painkillers. Her mother-in-law passed away before the health care ended.
“You feel almost like a relief, a cynical thing to say, but a relief that she did not live to the day after which she would get no help, no medications, and suffer more,” Chernova said.
The law also prevents many immigrants from purchasing government-subsidized health insurance plans beginning in 2027. For many families, full-price health insurance plans are expected to be out of reach financially.
Health policy experts warn the loss of coverage could further strain local governments and public health systems.
“People who lose access to Medicaid, who lose access to behavioral healthcare don’t simply get better on their own,” said Mark Ritacco, a senior policy advisor with Manatt, Phelps & Phillips LLP. “They end up showing up for county services more often than they would otherwise.”
Originally, about 14,000 Washington residents were expected to lose coverage. However, Gov. Bob Ferguson signed state-level protections that allowed roughly 3,000 people to keep their insurance. King County Councilmember Teresa Mosqueda is calling on King County to take similar action as communities like Los Angeles County to support healthcare programs.
“We know we cannot backfill every dollar that is cruelly being ripped away from the federal government, but we can act to strengthen our safety net and protect our residents with the onslaught of health care attacks underway,” Mosqueda said during a virtual press conference.
And additional changes are on the way.
Starting Jan. 1, more than 600,000 Washington residents enrolled in Apple Health will face work requirements for the first time to maintain coverage. Participants will also be required to renew their eligibility twice as often.