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This page will continue to be updated as the Washington State Health Care Authority (HCA) releases more information. – Last updated: October 2, 2026
New federal rules change eligibility
At least 200,000 people in Washington are projected to lose Apple Health (Medicaid) coverage by the end of 2027, and it’s estimated that a family of four could lose the equivalent of 360 meals per year – a meal per day – due to H.R. 1, a 2025 federal budget bill, which added new requirements and changes to these programs. [1, 2]
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 Apple Health (Medicaid) this year, and the impacts of SNAP changes that have already taken effect.
Guidebook on Federal Changes
This guidebook supports the Community Based Workforce in navigating SNAP & Apple Health eligibility with clients.
Become a Volunteer Assister: Virtual Training
Train as an enrollment navigator. This is especially valuable for clients who need support in languages other than English.
Visit the Apple Health Eligibility Screener Tool
Use the HCA’s screening tool to see whether upcoming H.R. 1 changes could affect your coverage or eligibility, and learn what you may need to do.
Apple Health
Open Enrollment for Apple Health: November 1 – December 15
This is the busiest and most important window to help clients renew.
Apple Health is Washington’s name for Medicaid — no-cost health coverage for low-income families and individuals. 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 — no changes to their eligibility or coverage.
- – There are additional exemptions and exclusions. See HCA’s guidance for the full list.
Key Dates
Eligibility for refugees, asylees, and other noncitizen adults is narrowing to specific immigration statuses.
[Fact sheet: English | Español | 14 more languages]
Adults on Apple Health will need to work, train, or do community engagement 80 hours/month, with some exceptions.
[Fact sheet: English | Español | 14 more languages]
Adults on Apple Health will renew coverage every 6 months instead of every 12.
[Fact sheet: English | Español | 14 more languages]
Retroactive coverage drops from 3 months to 1 month (Adults) or 2 months (all other Apple Health programs).
[Fact sheet: English | Español | 14 more languages]
Adults on Apple Health may pay up to $35 for some services. Primary care, behavioral health, emergency care, and certain rural services are excluded.
Supplemental Nutrition Assistance Program (SNAP)
The new federal law means more people on SNAP now have to meet work requirements. These changes went into effect on December 1, 2025. Those most affected are called Able-Bodied Adults Without Dependents (“ABAWD”).
Make sure the state has your current contact information (address, phone number and email). Update your information at Washington Connection, and respond right away to any notice you receive.
Updates to ABAWD classification – if these apply to you, with income eligibility, you now have work requirements:
- Age 18-64 (increased age range)
- Veterans
- Former foster youth
- People experiencing homelessness
See exemptions and further information on the CACH Benefits Guidebook.
Additional Resources
- – Coalition of ACHs: H.R. 1 webinar slide deck
- – HCA: Changes coming to Apple Health (continuously updated)
- – HCA: Join an upcoming virtual forum
- – HCA: Social media toolkit, for organizations to spread the word
- – Free enrollment navigation program
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) or the Department of Social and Health Services (DSHS). Rules and implementation details may change as these agencies receive additional guidance.
