Medicaid Changes: What it means for your community and what you can do

This page will continue to be updated as the Washington State Health Care Authority (HCA) releases more information. – Last updated: September 16, 2026

At least 200,000 people in Washington are projected to lose Apple Health coverage by the end of 2027 because of federal legislation changes.

North Sound ACH is working with the Washington State Health Care Authority (HCA) and the Coalition of ACHs (CACH) on public awareness regarding changes to Medicaid (Apple Health) happening this year.

Change is easier to navigate when we navigate it together.

This page provides plain-language information to help North Sound communities understand what changes are coming. Please note that this is not a substitute for an eligibility determination or individualized advice from the Washington State Health Care Authority (HCA). Rules and implementation details may change as the HCA receives additional guidance.

About Apple Health & H.R. 1

Apple Health is Washington’s name for Medicaid — no-cost health coverage for low-income families and individuals. H.R. 1, a 2025 federal budget bill, adds new requirements and changes to Apple Health. Most changes take effect at a client’s next renewal after each change is implemented.

Quick Facts

• – Apple Health for Adults will now have work requirements, shorter renewal timelines, and some cost-sharing.
• – For those enrolled in Apple Health, it’s important to keep their contact information up to date – Apple Health clients will receive notices about potential changes to their coverage.
• – There is a free enrollment navigation program in every county, so clients can ask questions and get help with their applications.
• – Who’s exempt from the new work requirements:
  • – People on Apple Health pregnancy coverage
  • – Tribally enrolled American Indians and Alaska Natives
  • – Children age 19 and under are not affected by H.R. 1 at all — no changes to their eligibility or coverage.
  • – There are additional exemptions and exclusions. See HCA’s guidance for the full list.

How you can help

Support your community members with information and resources regarding changes to Apple Health.

Key Dates

Become a Community Connector in North Sound

At North Sound ACH, we believe everyone deserves access to quality, affordable health and social care — without barriers. This is why we’re sharing trusted, plain-language guidance so communities can prepare, know their rights, and connect with resources.

We’re asking community-based organizations that support Medicaid-eligible clients to become Community Connectors for our region.

As a Community Connector, your organization can:

• – Share clear, accurate information using approved resources and messaging
• – Direct clients to free enrollment navigation and language-access support
• – Stay informed through Community Connector webinars and email updates

Become a HCA Volunteer Assister

If you work directly with Medicaid-eligible clients, the Washington State Health Care Authority (HCA) has opened a pathway for you to become a Volunteer Assister — a trained, individual enrollment navigator. This is especially valuable for clients who need support in languages other than English.

What’s involved:

• – Self-paced training
• – An assessment test
• – A Washington State Patrol background check

We encourage you to apply if you have time and capacity to help — especially during Open Enrollment (November 1–December 15).

Messaging, FAQs, and Other Resources

• – HCA: Changes coming to Apple Health (continuously updated)
• – HCA: Join an upcoming virtual forum
• – Free enrollment navigation program