Grantee: Northwest Health Law Advocates (NoHLA)
Timeframe: July 2025 – June 2027 | Amount: $162,400
- Year 1: July 2025 – June 2026 | Amount: $80,000
- Year 2: July 2026 – June 2027 | Amount: $82,400
Northwest Health Law Advocates (NoHLA) is working to defend and expand affordable health coverage for immigrants in Washington State during a period of intense federal and state policy instability. Building on progress supported by 2025 PHPDA funding, NoHLA continues to protect two newly created Washington State programs for undocumented adults—Apple Health Expansion and Cascade Care Savings—both of which face significant threats due to federal policy changes, state budget shortfalls, and rising community need. As federal actions such as H.R. 1 eliminate federally funded coverage for more than 45,000 lawfully present immigrants, NoHLA has focused on safeguarding state programs and educating King County communities.
In Year 1, NoHLA contributed to major policy developments. They provided technical expertise to the King County Board of Health, helping shape a new county premium sponsorship program for lawfully present immigrants who lost federal subsidies. They also supported Washington State’s Attorney General by submitting a declaration in litigation that resulted in a temporary injunction blocking federal immigration authorities from accessing private Medicaid data. NoHLA produced multilingual public education materials on data privacy, federal policy changes, public charge, and statewide health coverage options. They coordinated large coalition sign‑on letters urging improvements to state programs and opposing harmful federal proposals, and they delivered 8 educational presentations while responding to 30 technical assistance requests. Their immigrant health implementation workgroup met 16 times, serving as a key setting for addressing enrollment barriers and coordinating advocacy.
NoHLA’s work has unfolded amid significant challenges. Federal actions have heightened fear in immigrant communities, especially after revelations that Centers for Medicare and Medicaid Services (CMS) shared Medicaid data with the Department of Homeland Security (DHS). H.R. 1 has stripped federal subsidies from Deferred Action for Childhood Arrivals (DACA) recipients and lawfully present immigrants under the poverty level, significantly increasing premiums and pushing more than 10,000 people into the already lengthy Apple Health Expansion waitlist. Additional groups—including refugees and asylees—will lose federal Medicaid beginning in late 2026. Washington State also faces a major revenue shortfall and must prepare for up to 250,000 residents losing Apple Health due to new federal work reporting requirements.
These pressures created a real risk that Washington State would defund immigrant health programs. The state’s December 2025 budget proposed cutting Apple Health Expansion by more than 40% and reducing benefits to a limited set of services. NoHLA’s education and advocacy helped prevent these cuts from being adopted, and both House and Senate budgets later proposed significantly higher funding levels and stronger privacy protections.
Looking ahead, NoHLA will continue its four‑part strategy: producing multilingual educational materials, facilitating a biweekly implementation workgroup, conducting at least 8 know‑your‑rights trainings (with a focus on King County), and providing direct technical assistance to resolve enrollment and access issues. In Year 2, NoHLA plans to deepen community input efforts, expand education on state revenue options, and increase its focus on privacy and safety as federal threats escalate.
NoHLA’s advocacy will affect approximately 14,000 current enrollees in Washington State immigrant health programs, more than 25,000 people on the Apple Health Expansion waitlist, and an estimated 45,000 lawfully present immigrants who will newly need state coverage due to H.R. 1.
ABOUT OUR GRANTEE
Northwest Health Law Advocates (NoHLA)
“At Northwest Health Law Advocates (NoHLA), our mission is to ensure that every individual in Washington has access to quality, affordable health care. We are dedicated to eliminating barriers and unfair practices that prevent people from receiving the care they need. Through advocacy, education, and legal support, we strive to create a health care system that is equitable and just for all.”
