As part of our efforts to protect health care access in WA, NoHLA and SEIU 775 delivered the following request to Attorney General Nick Brown and colleagues (reflected in CC below the message). The request urges state action to protect immigrant Washingtonians' access to the life-sustaining long-term care they depend on. Without action, nearly 1,500 Washingtonians are slated to lose access October 1, 2026.
Request to Attorney General Brown
Subject: Request for State Action to Protect Washington Immigrants Losing Care
Dear Attorney General Brown and colleagues:
Please find below/attached a request for your office's urgent attention to an emerging health care crisis impacting immigrant Washingtonians. We have copied others engaged in this important conversation. Thank you for your consideration.
Letter
July 29, 2026
Attorney General Nick Brown
Sent via email
Re: Request for State Action to Protect Washington Immigrants Losing Care Due to H.R. 1
Dear Attorney General Brown:
We deeply appreciate your commitment to protecting non-citizen Washingtonians from the onslaught of federal policies that seek to strip them of their rights and entitlements. As the current federal administration is preparing to stretch the destruction of H.R. 1 well beyond the limits of the law, we write to encourage your office to file litigation protecting essential health & long-term care for ~1,000 very low income, medically fragile non-citizens who will otherwise lose access to federally-funded Medicaid services on October 1st due to a fundamentally flawed interpretation of the federal H.R. 1 law.
Background
Under H.R. 1, the federal government plans to withhold Medicaid funding for nearly 1,500 lawfully present Washingtonians who rely on life-sustaining Medicaid long-term care, starting October 1, 2026. Washington, however, could bring a legal action to challenge these funding cuts. This could protect federal funding for an estimated 1,000 people who are Medicaid long-term care and Supplemental Security Income (SSI) beneficiaries, as well as any additional SSI and Medicaid beneficiaries who are not receiving long-term care.
Legal Issue
Ignoring two prior enacted and more specific laws that require Medicaid coverage for SSI beneficiaries, the Centers for Medicare and Medicaid Services (CMS) is wrongfully interpreting H.R. 1 to cut federal Medicaid funding for every non-citizen who is not a Lawful Permanent Resident, a Cuban or Haitian entrant, or an individual who resides in the U.S. in accordance with a Compact of Free Association, regardless of whether they are SSI beneficiaries. Importantly, H.R. 1 did not amend either of the two prior laws, which explicitly mandate Medicaid coverage for all SSI beneficiaries. See U.S.C. § 1612(b)(2)(F) (stating SSI beneficiaries “shall be eligible” for Medicaid services); 42 U.S.C. § 1396a(10)(requiring Medicaid State plan to cover SSI beneficiaries). Washington could seek a court order to properly limit the scope of H.R. 1 cuts and safeguard the essential services that SSI beneficiaries rely upon.
Agency Impact
These funding cuts not only jeopardize resources for life-sustaining care, but are bound to sow more chaos in the health care system. Washington has what’s called a “1634” agreement with the Social Security Administration (SSA) to simultaneously determine SSI and Medicaid eligibility, which is part of Washington’s Medicaid State Plan and authorized by the Medicaid Act. When SSA determines eligibility, it does not presently provide information about the beneficiary’s immigration status. As such, we are concerned that Washington has no practical way of accurately identifying which SSI beneficiaries are non-citizens or conducting the mandatory “ex parte” administrative data review to confirm ineligibility.
To the best of our knowledge, CMS has not required Washington to amend its State Plan nor provided any written implementation guidance, leaving Washington at risk of later error claims based on lack of practicably attainable information and CMS’s erroneous interpretation of H.R. 1. A federal legal action is thus further necessary to proactively clarify that H.R. 1 does not require Washington to design and implement a complicated system to terminate coverage for beneficiaries that SSA determines eligible for SSI and Medicaid.
Human Impact
The ~1,000 Washingtonians impacted by this issue are elders and people with disabilities who depend on caregivers to assist with basic life activities, such as eating, bathing, and toileting. They are immigrants who came to Washington lawfully as refugees, asylees, survivors of trafficking, and more. They include people like Hanna, an 85-year old with advanced Parkinson's and dementia who fled the Ukraine due to repeated missile attacks – only to now face additional trauma in the country and state that offered her safe haven.
Budget Impact
If Washington does not move forward with litigation to protect this group, the 2027 Legislature will face difficult decisions about how to best prioritize limited state funds. While this group of Washingtonians has acute care needs, they are also highly costly. Successful litigation could delay or stop the federal government from withdrawing federal funds to support this group, freeing up state resources to care for others losing coverage due to H.R. 1.
We thank you for your tireless work on many fronts to protect Washingtonians from the harms of the current federal administration. We ask you to continue prioritizing our immigrant community and take action to stop this most imminent attack. Given the quickly-approaching October 1st timeline, our organizations are committed to quickly mobilizing to stand alongside your office in defending the essential health care of Washington’s elders and people with disabilities. Thank you for considering this request.
Sincerely,
Emily Brice, Co-Executive Director
Susan Kas, Senior Attorney
Northwest Health Law Advocates
Adam Glickman, Secretary-Treasurer
SEIU 775
cc:
Office of the Attorney General: David Postman, Noah Purcell, Enoka Herat, Adam Eitmann, Will McGinty
Office of the Governor: Shane Esquibel, Sahar Fahti, David Frockt, Caitlin Safford, Grace Huang, Kristin Beneski
Health Care Authority: Director Ryan Moran, Trinity Wilson, Evan Klein
Dept. of Social and Health Services: Secretary Angela Ramirez, Bea Rector
Rep. Nicole Macri
Learn More
- In early August, NoHLA joined SEIU 775 and our No Cuts to Healthcare coalition partners, Washingtonian immigrants and caregivers, Congresswoman Pramila Jayapal, Senator Manka Dhingra, community, and press for a public roundtable to raise awareness about this emergency. We encouraged Washingtonians to join us in urging state leaders to take action.
- H.R. 1 Impact on Washington Immigrants and Refugees, by WA Dept. of Social and Health Services (DSHS)
- What Immigrants Should Know About Eligibility for Federal Public Benefits, by DSHS
- Changes Coming to Apple Health (Medicaid), by WA Health Care Authority