Health coverage is one of the most important tools for staying well, and for many people in Washington, that coverage comes through Apple Health (Washington’s Medicaid program). A federal law passed in 2025, known as H.R.1, is bringing several changes to Apple Health and to insurance purchased through Washington Healthplanfinder. Most of these changes start in January 2027, which means now is the time to get ready to ensure you keep your coverage!
The good news: many people will be able to keep their coverage without much extra effort, and help is available if you need it.
Who is affected?
The biggest changes apply to Apple Health for Adults, the program for adults ages 19 to 64 with lower incomes. These changes do not affect children, seniors, or other Apple Health programs. They also don’t apply to pregnancy coverage.
What’s changing?
Work and community engagement requirements. Beginning January 1, 2027, adults on Apple Health for Adults will need to meet work requirements or qualify for an exemption to keep their coverage. You can meet the requirement in several ways.
You qualify if you have at least $580 in monthly household income (or an average of $580 over six months for seasonal workers), are enrolled in school at least half-time, or spend at least 80 hours a month in a work program or community service. A combination of these activities that adds up to 80 hours a month also counts.
Renewals every six months. Coverage periods for Apple Health for Adults will shift from 12 months to 6 months, with the change taking effect at your first renewal in 2027. That means you’ll need to watch your mail and messages more closely than before.
Changes for some immigrants. Eligibility changes for some noncitizens begin October 1, 2026. State-funded Cascade Care Savings remain available to people of any immigration status who qualify based on income.
Coming later: co-pays. New cost-sharing requirements are scheduled to begin October 1, 2028.
You may already qualify for an exemption
Many people won’t have to report work hours at all. Exemptions include people who are pregnant or postpartum, parents or caretakers of children under 14, caregivers of someone with a disability, American Indians and Alaska Natives, people in households receiving SNAP or TANF, people entitled to Medicare, former foster youth under 26, veterans with a 100% disability rating, people who were recently incarcerated, people facing a short-term hardship, those who are medically frail, and people in alcohol or substance use disorder treatment.
This is especially important for people receiving behavioral health care. HCA has confirmed that a disabling mental disorder is included in the definition of medically frail, and so is opioid use disorder. If you’re receiving mental health or substance use treatment, talk with your care team about whether an exemption applies to you.
The state will try to verify you automatically
You won’t necessarily need to gather paperwork. HCA plans to use data it already has to confirm eligibility first and request documents only when it can’t verify something, and current data suggests about 64% of people are expected to qualify this way. If you do receive a request for information, you’ll have 30 days to submit documents by email, mail, or in person, and more time may be available if you ask.
Five steps to protect your coverage
- Update your contact information now. Make sure your address, phone number, and email are current in your Washington Healthplanfinder account. If notices can’t reach you, you could lose coverage without realizing it.
- Open every letter and message. HCA will begin contacting clients individually about three months before their renewal, starting in September 2026. Don’t set these aside.
- Know whether you meet the requirement or an exemption. Look at the lists above. You’ll need to meet the requirement or an exemption in the month before you apply, or in any of the six months before you renew.
- Keep simple records. Pay stubs, school enrollment letters, volunteer hour logs, or letters from a provider can help if you’re asked for proof.
- Don’t skip care, and ask for help. Changes to your coverage are not a reason to stop treatment. Our staff can help you understand your options and connect you with support.
If you buy insurance through Washington Healthplanfinder
Open enrollment for 2027 runs November 1, 2026, through January 15, 2027; sign up by December 31 for coverage starting January 1, while plans chosen January 1-15 start February 1. A few other changes are worth knowing. Starting January 1, 2027, federal financial help will be limited to lawful permanent residents, Cuban-Haitian Entrants, and COFA migrants, and people who received too much financial help for 2026 will have to repay the full amount when they file taxes. People denied Apple Health for not meeting work requirements also won’t be eligible for premium tax credits. Log in during open enrollment, update your information, and confirm your plan rather than assuming it will carry over.
Where to get help
- Comprehensive Healthcare: Walk into any of our outpatient clinics to talk with our trained staff about your options.
- Washington Healthplanfinder: Call the Customer Support Center at 1-855-923-4633 or find a free in-person assister through the Support in Your Area tool at wahealthplanfinder.org
- Washington State Health Care Authority: https://www.hca.wa.gov/free-or-low-cost-health-care/what-s-changing-apple-health-medicaid
Your health matters, and so does your coverage. A few small steps now can help make sure you and your family stay covered in 2027 and beyond.
Sources
Washington State Health Care Authority. “Apple Health (Medicaid) work requirements.” https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-medical-dental-or-vision-care/apple-health-medicaid-work-requirements
Washington State Health Care Authority. “Work Requirements and 6-Month Renewals Fact Sheet.” June 2026. https://www.hca.wa.gov/assets/free-or-low-cost/hr1-work-requirements-and-renewals-fact-sheet.pdf
Washington State Health Care Authority. “H.R.1 Webinar Frequently Asked Questions.” April 2026. https://www.hca.wa.gov/assets/program/hr1-frequently-asked-questions.pdf
Washington State Health Care Authority. “H.R.1 Impacts to Apple Health Eligibility” (webinar presentation). February 26, 2026. https://www.hca.wa.gov/assets/free-or-low-cost/hr1-impacts-webinar-series-1.pdf
Washington State Health Care Authority. “Impacts of H.R.1 on Apple Health Eligibility – Summary.” https://www.hca.wa.gov/assets/program/impacts-hr1-ah-eligibility-summary.pdf
Washington State Health Care Authority. “H.R.1 Impacts to Apple Health Overview and Verification Hub” (presentation to the Workforce Training and Education Coordinating Board). April 2026. https://wtb.wa.gov/wp-content/uploads/2026/04/3-HCA-Workforce-Board.pdf
Washington Healthplanfinder. “Federal Changes and Updates.” https://www.wahealthplanfinder.org/us/en/health-coverage/new/federal-changes-and-updates.html
Washington Health Benefit Exchange. “H.R.1 Medicaid Impacts” (advisory committee presentation). April 23, 2026. https://www.wahbexchange.org/content/dam/materials/communications/committees-and-workgroups/advisory/2026/HR1_Medicaid_Impacts_042326.pdf
UW Medicine. “Apple Health (Medicaid) and Health Benefit Exchange Changes: What You Need to Know.” July 2026. https://www.uwmedicine.org/patient-resources/billing-and-insurance/washington-health-benefit-exchange/apple-health-changes
