What counties or community clinics in Washington provide free or sliding-scale care to uninsured undocumented people?

1. The statewide safety net is large and often welcoming — but not uniform in practice

Washington maintains a network of 27 community health centers that operate across urban and rural counties and report policies of serving people regardless of ability to pay, which allows many uninsured and undocumented residents to access primary care, dental, behavioral health and specialty services on a sliding scale or for free in some cases ^{[7] [1]}. The centers receive substantial Medicaid payments and state support, yet each center sets its own sliding-scale fee schedules, charity care policies, and documentation requirements; therefore, county-level availability and the scope of “free” services vary, and clinics may prioritize different services (primary care, maternity, dental) based on local funding and capacity ^{[7] [6]}. Patients should verify service scope and payment policies with the clinic before seeking care.

2. New state policies expanded coverage pathways for some undocumented residents — a changing landscape

Beginning November 1, 2023 and with the Apple Health Expansion effective July 1, 2024, Washington allowed all residents to purchase plans through Washington Healthplanfinder and expanded Apple Health eligibility for certain low-income undocumented adults, creating an alternative to clinic-based sliding-scale care for many people ^{[3] [2]}. These state-level changes reduce reliance on charity care for some undocumented residents who meet income thresholds, but not all undocumented people qualify for expanded Apple Health and some still lack eligibility, making community clinic networks and county programs essential for those left uninsured ^{[2] [8]}. Clinics often help patients navigate enrollment, but capacity and navigator availability differ by site ^[5].

3. Examples: clinics and county programs that explicitly serve undocumented and uninsured patients

Several community clinics and organizations publicly state they provide care without requiring proof of citizenship and offer sliding-scale discounts or charity care, including Seattle Roots Community Health, ICHS (International Community Health Services), and multiple Federally Qualified Health Centers listed across the state’s clinic directory ^{[5] [9] [1]}. The statewide directory and clinic networks list county-level providers in Chelan, Douglas, Spokane, Pierce, Yakima, Snohomish and King counties among others, indicating a distributed network where uninsured undocumented people can seek care ^{[1] [4]}. Clinics vary in required documentation—many request income verification for sliding-scale fees—but explicit non-discrimination on immigration status is commonly stated.

4. Practical steps to find care locally and what to expect at intake

Use the state clinic directory and Washington Healthplanfinder resources to locate nearby community health centers and to learn about eligibility; call ahead and ask about sliding-scale fees, charity care, language services, and whether immigration status is a barrier to enrollment or services ^{[4] [2]}. Expect clinics to request income proof (pay stubs, affidavits) to determine sliding-scale eligibility; many clinics also offer insurance navigators to apply for Apple Health or Marketplace plans when eligible, reducing out-of-pocket costs ^{[5] [9]}. If you encounter unclear policy language, contact local immigrant assistance organizations and hotlines listed by state resources for confidential help ^[8].

5. Funding pressures and policy risks that could change access at the county level

Community clinics report financial strain from federal policy uncertainty and shifting Medicaid rules, which could force service reductions or tougher eligibility choices despite current commitments to serve all patients regardless of immigration status ^[7]. While state expansions have improved coverage options, the sustainability of uncompensated care depends on federal, state, and local funding flows; clinics in rural counties particularly rely on variable funding streams and may have limited specialty or dental capacity ^{[7] [6]}. Patients should therefore verify current services with clinics and seek up-to-date guidance from statewide navigators and community organizations when planning care ^{[4] [2]}.