Community-based workers are often the first people community members turn to when a letter arrives or coverage stops. H.R.1, a federal law signed in July 2025, is changing Apple Health (Washington's Medicaid program) in phases through 2026 and 2027. This guide brings together what has changed, what is coming, and the resources you can use and share with the people you serve.

If you or someone you know relies on Apple Health(Washington's Medicaid program) or SNAP food assistance, changes are coming that could affect your coverage. These changes come from H.R.1, a federal law that was signed last year and is now being phased in through 2026 and 2027.

The good news: most of these changes don't happen all at once, and most people who are currently eligible will stay eligible if they take a few key steps.

Here's what's changing, when it's changing, and where to get help.

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Two waves of change, not one

It's easy to assume these changes all land on a single date. They don't. There are two distinct waves, and knowing which one applies to a person matters.

Wave one, October 1, 2026:

Apple Health eligibility ended for adults with certain immigration statuses. The Washington Health Care Authority (HCA) estimates this affects about 14,000 people statewide. HCA and DSHS began sending notices to affected clients in July.

Wave two, January 1, 2027:

New work requirements and a move from yearly to six-month renewals begin for Apple Health for Adults (ages 19 to 64). Retroactive coverage, which helps pay medical bills from before someone applied, also gets shorter. It drops from three months to one month for Apple Health for Adults and to two months for other Apple Health programs. This wave affects far more people, and renewals repeat every six months.

Understanding this distinction matters because the October changes are narrow but urgent, while the January changes are broader but come with more lead time to prepare.

Who is affected as of October 1

Adults with the following immigration statuses are no longer eligible for Apple Health, unless they also hold a status that remains eligible, such as a green card:

• Asylees‍
• Conditional entrants‍
• Refugees‍
• Individuals for whom deportation or removal has been withheld
• Survivors of human trafficking
• Violence Against Women Act (VAWA) self-petitioners
• Parolees

Children under 19, pregnant people, and people within 12 months postpartum can remain eligible for Apple Health regardless of immigration status, as long as they meet all other requirements.

If a person fall into one of the groups above, advise them to watch their mail for a notice from the state, and don't wait to respond. Advise them to reach out to a case manager now to understand what documentation they may need.

A note on DACA recipients

DACA recipients are affected by recent federal changes, but in a different way than the groups listed above. As of October 1, 2025, people with DACA status no longer qualify for federal tax credits on health plans bought through Washington Healthplan Finder. DACA recipients in Washington can still buy a health plan through Washington Health Plan Finder and may qualify for Cascade Care Savings, the state-funded premium assistance program available regardless of immigration status. Encourage DACA recipients to update their application and connect with a navigator to review their options.

What's changing in January 2027

Starting January 1, 2027, people on Apple Health for Adults will need to either meet a new work requirement (80 hours per month of work, school, training, or community service, or meet an income threshold) or qualify for an exemption. Renewals will also move from once a year to every six months for this group.

Many people who fall under this requirement will still be eligible for coverage. The most common reason people lose coverage under rules like this isn't that they no longer qualify. It's that paperwork or a missed deadline gets in the way. That's exactly where local case management can make the difference, and it's a core part of why HealthierHere exists.

For others, missing paperwork or a missed deadline is a common reason people lose coverage they still qualify for.

You can help the people you serve by reminding them:

• Keep their address and phone number current with AppleHealth
• Open every notice and respond right away (people have 30 days to respond to a notice of noncompliance)
• Start tracking hours now if they will need to meet the work requirement
• Apply for coverage as soon as they need it, since retroactive coverage shortens to one month for Apple Health for Adults

Tools and Resources

‍Coalition of ACHs Quick-Reference Guide: The Coalition of Accountable Communities of Health's SNAP and Apple Health Changes Quick-Reference Guide for Community-Based Workers covers eligibility, exemptions, work requirements, and SNAP changes in plain language, with printable action pages to hand to clients.

HealthierHere H.R.1 Non-Citizen Impacts Toolkit: Customizable social media and email language to help you communicate these changes to the communities you serve.

H.R.1 Multilingual Flyers for Immigrant and Refugees: The Washington Immigrant Information Center offers plain-language articles, a printable infographic, and short videos on the Apple Health changes in multiple languages, plus a free help line at +1 (206) 672-4226. Watch their multilingual short video series on YouTube.

HCA's H.R.1 Provider Toolkit: HCA summarizes each change, who is affected, and key messages for trusted messengers.

Supporting the people who support our community

HealthierHere supports community-based workers and the organizations that work directly with community members to access and navigate care. As H.R.1 changes continue to roll out through 2026 and 2027, we will keep sharing accurate information, tools, and resources to help you support the people you serve. Thank you for the work you do to keep your communities informed and connected to care.
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