As a pediatrician and child psychiatrist, I care for children with autism, intellectual disabilities and complex medical needs. Some of my patients are refugees.

Over the years, I have listened to stories that most Americans can scarcely imagine. Families fleeing civil war. Children growing up amid bombings. Parents watching loved ones murdered. Families surviving hunger, violence and displacement before finally being resettled in the United States.

One family in particular stays with me.

They are refugees from Syria. Before escaping to Turkey and eventually being resettled in the United States, they spent months living in bombed-out apartment buildings, moving from place to place in search of safety. One night, during an air raid, they woke to the sound of explosions and rushed to flee their building. As they prepared to run, they went to wake their disabled son.

They found him in the middle of a grand mal seizure. It was the first of what would become thousands of seizures over the following years.

Imagine that moment. A family kneeling beside their convulsing child while bombs fell around them. Praying that the seizure would stop. Praying that the building would still be standing in the morning.

Not only did they survive war. They survived it while caring for two severely disabled children.

Their resilience is extraordinary.

Today they live in Utah. The parents work. Like nearly every refugee family I know, they want to support themselves. They are grateful for safety and opportunity. Yet they face enormous challenges. Language barriers. Limited employment opportunities. Low wages. The lingering effects of profound trauma.

And now many refugee families face another challenge.

Under the One Big Beautiful Bill Act passed last year, many refugees who have not yet obtained permanent resident status stand to lose access to Medicaid, SNAP and other forms of assistance. Refugees are required to apply for permanent residency after one year in the United States, but actually obtaining a green card often takes considerably longer. This has only been made worse over the last year, as additional vetting, re-interviews, processing pauses and other newly introduced measures have left many families in limbo.

The result is simple: Families who are legally here, who were invited here through America’s refugee resettlement program, who are working and paying taxes, may suddenly find themselves without health insurance and without food assistance.

Who will care for them?

That is not a rhetorical question.

Many of the lawmakers who supported these changes say they believe that government should play a limited role in caring for the poor. They argue that responsibility should instead fall to families, churches, charities and local communities.

If that is the vision, then we should discuss it honestly. Who will care for them?

Will charitable organizations have the resources to provide medical care for children with epilepsy, autism and developmental disabilities? Will food banks be able to absorb the increased need? Will local communities be prepared to support families who are already struggling to make ends meet?

In Utah, another question naturally follows.

Will The Church of Jesus Christ of Latter-day Saints step forward? The church has a long and admirable history of supporting refugees. Its members have donated time, money, clothing, housing and countless hours of service. Many refugee families in Utah have benefited from that generosity.

Will that support now expand to fill the gap?

Will the state government step in?

Will our elected leaders explain how these families are expected to obtain food, medications, therapies and medical care?

Or will we simply look away?

I know these families. I have sat with them in clinic rooms. I have watched parents struggle to navigate a foreign language, an unfamiliar culture and a complex medical system while caring for children with profound disabilities. I have seen their determination and their gratitude. I have seen their trauma.

Many did not choose to come here. They were resettled here because returning home would have placed them at grave risk of persecution, imprisonment or death.

America made a commitment to these families. We cannot invite them here, celebrate their resilience and then abandon them.

The United States is the wealthiest nation in the history of the world. Utah is among the most prosperous states in the country. If refugee children go hungry, if disabled children lose access to medical care, if families who fled war are left without support, it will not be because we lack the resources to help them.

It will be because we chose not to.

That should trouble all of us.

And it should prompt a simple question for every elected official who supported these changes: Who will care for them?

Spencer Merrick, MD, is a pediatrician and child and adolescent psychiatrist in Utah.

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