As a bilingual health advocate at the nonprofit ABC for Health, Nick Grobarchik had many clients who, because of their immigration status, didn’t qualify for traditional Medicaid but were eligible for emergency Medicaid programs. Some had end-stage renal disease — a diagnosis where getting quick access to health insurance is a matter of life or death.

Grobarchik worked with one Spanish-speaking client for two years, helping him fill out paperwork that allowed him access to dialysis and medication. He also spent months trying to get the dialysis provider to act on a financial assistance application. 

“There’s no way that the family would be able to work through this without my help,” says Grobarchik, adding that ABC for Health is a rare organization that helps clients navigate complex health insurance matters.

Grobarchik won’t be there to support this client through insurance renewal in a few months, or to help resolve new debts for anyone else. His last day at ABC for Health was Sept. 30.

Grobarchik is one of five client-facing workers at the small health nonprofit who was laid off. It’s not the first time the group, which counsels individual clients while advocating for broader systemic reform, has had to shrink.

Individual counseling “does ebb and flow related to funding,” says Bobby Peterson, founder and executive director for ABC For Health. While the nonprofit made it through the first year of the second Trump administration, Peterson says they knew that dwindling federal funding would make 2026 a year of “rough sledding.”

The ‘ABC’ in ABC for Health is short for Advocacy and Benefits Counseling. The nonprofit was founded by Peterson in 1994 after a stint working at another public interest law firm.

“I felt like we needed to really zero in and focus on access to healthcare coverage and services for children and families,” says Peterson. “They were really kind of getting the short end of the stick sometimes in terms of funding and support. They still do.”

Now, ABC for Health is in the midst of strategic and succession planning that will last until at least the middle of 2027. The pause will help the nonprofit’s leaders develop a “game plan for what comes next,” says Brynne McBride, the nonprofit’s chief operating officer.

One consideration is how much to “get off the hamster wheel” of helping clients directly, and whether to lean more into “systems change work.”

What does “systems change” look like? McBride points to a long-running campaign against the “birth tax” — charging unwed fathers the cost of childbirths that are covered by Medicaid.

McBride says they could have spent their time helping potentially tens of thousands of clients individually affected by that policy. Instead, she says their advocacy has helped to wipe away $77 million in debt through policy change. Milwaukee County discontinued the birth tax in its 2024 budget. Dane County eliminated its claims in 2020, and stopped pursuing payments in 2023.

During their succession planning, most would-be clients are being referred to other organizations. Counseling for clients in rural parts of the state has continued, under a grant received by ABC For Rural Health, another of the nonprofit’s subsidiaries. Otherwise, clients are being referred to Covering Wisconsin, local Aging and Disability Resource Centers, and Legal Action of Wisconsin.

Tim Hennigan, a former staff attorney at ABC for Health who was also laid off Sept. 30, said in August the on-the-ground experience of directly helping clients is part of the nonprofit’s “secret sauce.”

“We know what it's like to sit with them on hold with the Milwaukee enrollment services, trying to figure out how to get somebody a BadgerCare approval. That’s the kind of on-the-ground experience that you don't see a lot of in those sort of policy discussions.”

In April, staff at ABC for Health notified management of their intent to unionize with the National Organization of Legal Services Workers, UAW Local 2320, and asked for voluntary recognition.

They didn’t get it. Instead Peterson said in an email that planning options were in place “to conduct firm restructuring to address succession issues and to refine and improve agency administration.” He cited “financial realities” that dictated the need for change.

In total, seven staff unanimously voted to unionize in June after requesting an election from the National Labor Relations Board (in addition to the five laid off, one member left ahead of Sept. 30, and another remains employed). They learned in August that client services would soon end and client services staff would be laid off at the end of September.

These employees said in an August press release that they were “skeptical” disabout the timing of the layoffs, coming shortly after they successfully unionized.

Peterson and McBride say that they had been discussing succession plans with employees as early as January and February. “We feel bad about the whole process. But it’s not the first rodeo for us to go through this,” says Peterson. “Most people know that a nonprofit job doesn’t come with tenure.”

Both parties have since reached an agreement — departing staff members were offered two months of severance and three months of health insurance in exchange for retracting an unfair labor practice claim filed with the National Labor Relations Board in August. The union also agreed to take down a website critical of management, confirms Hennigan. Peterson and McBride declined to confirm details of the agreement.