1. The Refugee Health Program in Pierce County is designed to assist refugees, special immigrant visa holders, and asylees transition to life in the new environment. The program provides medical services such as immunizations, tested for HIV, STDs, and hepatitis B and C, emotional wellness, TB testing, stool testing, anemia and lead screening, physical exams, and referrals for other conditions including dental, vision, diabetes, and blood pressure complications.
2. The Medical PM/WAG has been updated for Asylum Applicants and Torture Victims (AATV), and Victims of Trafficking, Torture, or Other Serious Crimes (VTTC). This includes new procedures and policies regarding state-funded medical coverage versus federally funded Medicaid, “Derivative Family Members” (DFM) for VTTC cases, and verification of status for AATV and VTTC. Adult noncitizen applicants who don’t meet Medicaid-qualifying criteria may be evaluated for state-funded health benefits. State-funded health benefits may include noncitizens denied both federal Medicaid and state-funded health benefits, which make them eligible for health benefits through the Federal Facilitated Marketplace. These state-funded benefits are for Asylum Applicants and Torture Victims, Victims of Trafficking and Torture or other serious Crimes, and Health Benefits for Immigrant Adults/Seniors.
3. The October 2025 Visa Bulletin has released important actions for those waiting for an employment-based green card. Providing early and thorough preparation can expedite the approval process for those who have a pending I-485 and whose priority date is going to become current under the Final Action Dates chart. The Visa Bulletin regulates the pace of green card processing, including those with pending approval and those who can now submit an I-485. The guide advises on gathering key evidence, medical exams, supplementary forms, and filing strategies.
The Trump administration announced immediate changes to the green card application policy, as issued by the United States Citizenship and Immigration Services (USICS) on June 11, 2025. Whereas the previous policy allowed applicants to use a medical examination form indefinitely, the adjusted protocol stipulates that every new permanent residency application must include a recent medical examination form.
The policy change mainly impacts immigrants applying for adjustment of status whose prior medical forms would have been valid until June 10. Typically, USICS allows a grace period after announcing changes to application processes for applicants and immigration attorneys to prepare.
The policy change pertains to form I-693, referred to as the “Report of Immigration Medical Examination and Vaccination Record”, submitted by immigrants in the U.S. applying for adjustment of status or seeking to become permanent residents. Under previous rules, any I-693 completed and signed by a civil surgeon on or after November 1, 2023 could be used indefinitely and for multiple applications.
However, the new guidance asserts that an invalidated I-693 due to withdrawn applications requires a new exam for obtaining a fresh signed copy. This change may affect thousands of applicants currently trying to file their adjustment of status application, known as Form I-485. The medical exams, which can cost between $100 and $500, consist of physical checks for specific conditions or diseases that would make a person unfit for U.S. entry and checks for an applicant’s vaccination records.
Before the policy update, only applicants who needed to prove they were not medically unfit were required to submit the medical examination form. Now, all green card applicants must present this form, and other immigrants applying for unique visas can also be asked to submit an I-683 based on USCIS discretion.
As the Trump administration strengthens its crackdown on immigration law violators, immigrants applying for both temporary and permanent visas in the U.S. are facing increased scrutiny.
Green cardholders may be detained within the U.S. or denied reentry following travel abroad. This is not a new occurrence but has become more common since January 20. The federal government has repeatedly stated that green cards, which can be revoked on national security grounds, because of immigration law violations, or criminal convictions, do not signify citizenship.
The new policy, which began on June 11, 2025, will require a new version of the form to be used after July 3, 2025. This change indicates that the Trump administration is continuing its hardline stance on immigration, emphasizing the need for detailed scrutiny of every applicant. Despite these changes, reactions among experts in the immigration field have ranged from resignation at the increase in difficulty to relief that the changes remained relatively limited.
