Because of cruel cuts to care included in Trump’s HR 1, the “Big Ugly Bill,” thousands of immigrants stand to lose their healthcare and long-term care starting October 1, 2026. If your client is affected by these cuts, they would have received a letter from DSHS in August about changes to their eligibility for Apple Health (Medicaid) and long-term care services and will hear directly from their case manager before September 15, 2026.

Review the slides from DSHS’s August 18, 2016 webinar on changes to Medicaid eligibility because of HR 1 here.

Frequently Asked Questions:

Who is losing care?

On October 1, 2026, certain adult immigrants who are enrolled in federal Medicaid (Apple Health) and Long-Term Services and Supports will no longer qualify for these programs and, with limited exceptions, will lose their healthcare coverage if their immigration or citizenship status is:

  • Refugee
  • Asylee
  • Victim of Trafficking
  • Ukrainian Humanitarian Parolee; or
  • Immigrant with another form of humanitarian protection

If you or someone you know no longer qualifies for services because of your immigration status, update DSHS immediately if:

  • You’ve had a change in immigration status
  • You are pregnant or have been in the 12 months prior to October 1, 2026
  • You are receiving emergency medical services, cancer treatment, anti-rejection medication, or dialysis

When will my client hear from DSHS if they are losing care?

Informational letters from DSHS were mailed to clients who are likely to be affected by these cuts in August 2026. Case managers will reach out directly to impacted clients by September 15, 2026. If your client didn’t receive communication from DSHS, but you believe they will be affected by these cuts, reach out to their DSHS or AAA case manager.

Planned Action Notices will start mailing out from DSHS on September 1, 2026. The notices will tell you if:

  • Client has met eligibility for new Limited Benefit Community Access Program. If they are moved to this new program, they will have the same services they were receiving on September 30, 2026.
  • Client has not met the eligibility for Limited Benefit Community Access Program, and they will be added to the waitlist for the new program.

Official ACES Medicaid Termination Notices will be mailed to clients starting on September 14, 2026 from Public Benefit Specialists with the Home and Community Living Administration at DSHS. ACES is the Automated Client Eligibility System that determines client eligibility for programs like long-term care and Apple Health (Medicaid).


What State funded programs are available for clients losing coverage?

During the 2026 Washington state legislative session, caregivers and our Union fought hard and won funding in the budget to protect some immigrants from losing care. But in June, Trump’s Center for Medicare and Medicaid Services (CMS) accelerated the cuts. Now, the cuts are happening faster and going deeper than anyone anticipated, and the State dollars cover far fewer people than lawmakers expected. 

Because we spoke out, Washington state has funded a new program, called the Limited Benefit Community Access Program (LB-CAP) to provide long-term care for people losing it under HR 1. Your client will receive a Planned Action Notices will start mailing out from DSHS on September 1, 2026 to tell you if they are being moved to the Limited Benefit Community Access Program or are being put on the waitlist for it.

Details on the Limited Benefit Community Access Program includes:

  • It covers both Home & Community Services (HCS) and Developmental Disability Administration (DDA) programs.
  • Initial program enrollment will serve all current clients as of July 31, 2026, who:
    • Reside in a residential or 24/7 care facility, such as a Skilled Nursing Facility or Adult Family Home.

OR

  • Meet certain acuity levels for remaining slots.
  • As of August 18, 2026, 173 people, including 160 Home Care Services clients and 13 Developmental Disabilities Administration (DDA) clients, are eligible for this program and will continue to receive all services they are receiving on September 30, 2026.
  • DSHS will create a waitlist of people whose long-term care was cut by HR 1, but are not initially eligible for the Limited Benefit Community Access Program.
    • Clients will be prioritized based on CARE data (acuity) and length of time on services as of July 31, 2026, and,
    • Dependent upon funding
  • Once on the program, the client must retain functional and financial eligibility.

What community resources are there for me or my client after loss of care?

We will continue to fight for the life saving, state funded care that our clients count on. Here are community healthcare resources for you or your client, should you lose healthcare eligibility on October 1, 2026.

How can I get more hours or clients?

As an SEIU 775 member, you have access to Carina, a job-matching platform that helps you find people who need care and fit your schedule. It is a union benefit that puts you in control of who you connect with and when. It’s private, secure, and easy to use.

To get started:

Carina’s client listings change all the time, so if you don’t see a match right away, check back in a week or so — new jobs are added regularly.

SEIU 775 members with specific legal questions about immigration can contact our Member Resource Center from 8 a.m.-4:30 p.m. PT Monday-Friday at 1-866-371-3200 or email us at mrc@seiu775.org.

You can also visit our Immigration Defense Resources page for additional immigration resources.

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