3 things to know about upcoming changes to Apple Health (Medicaid)

New federal requirements are coming to Apple Health for some people. We break down what enrollees need to know to be prepared—and to stay covered.

Federal legislation. New rules. Work requirements. Confusing language. If you’ve been trying to figure out what’s actually changing with Apple Health (Medicaid) coverage, you’re certainly not alone.

Nearly 2 million Washingtonians rely on Apple Health as their health care safety net. For them, it’s more than just insurance—it could mean the difference between seeing a doctor and skipping care.

In 2025, Congress passed a bill that makes major changes to Medicaid eligibility for some people—starting as early as this fall. Gov. Bob Ferguson’s office has said at least 250,000 Washingtonians could lose coverage over time due to these federal cuts.

What to know

Here’s what to expect, who is affected, and what you can do now to be ready.

Work requirements (starting January 2027)

Apple Health for Adults enrollees (ages 19–64) must meet a work requirement unless they qualify for an exemption. You can meet this requirement in any of the following ways:

Completing at least 80 hours a month of work, community service, or a work program
Enrolling in an educational program at least half-time
Combining the above activities to total at least 80 hours a month
Having a monthly household income of at least $580

You must meet this requirement (or qualify for an exemption) in the month before applying, or in any of the six months before renewing coverage.

Who is affected?
This change only applies to people with Apple Health for Adults coverage. It does not affect any other Apple Health programs, including coverage for children, pregnancy services, or long-term care services. People exempt from this requirement include those who are pregnant or are medically frail.

Renewing every 6 months (starting January 2027)

Apple Health for Adults enrollees will need to renew their coverage every 6 months instead of the current once every 12 months.

Who is affected?
Like the work requirements, this change also applies only to Apple Health for Adults.

Immigrant eligibility changes (starting October 1, 2026)

Some immigrants—including refugees and asylees—will no longer be eligible for federally funded Medicaid coverage. Full Apple Health coverage will be limited to:

Green card holders who have met, or do not need to meet, the 5-year waiting period
COFA migrants (from the Marshall Islands, Micronesia, and Palau)
Cuban/Haitian entrants

Some other state-funded Apple Health programs, such as Emergency Medical (AEM) and Apple Health for Pregnant Individuals, will still be available no matter your immigration status, if you meet those programs’ eligibility rules.

What you can do now

The Washington State Health Care Authority (HCA), which oversees Apple Health, is still reviewing the full effects of the new rules and how to implement them. The agency says it is working to make the transition as smooth as possible for enrollees.

Keep your contact information up to date.

This is the most important step. This ensures you won’t miss important updates and notices.

Make sure your address, phone number, and email are current with:

Washington Healthplanfinder
Your health plan, such as Community Health Plan of Washington (CHPW)

Stay informed.

Watch for updates from HCA about steps to renew coverage. CHPW members can also check the Renew webpage.

Need support?

Navigating changes to your health insurance can feel overwhelming, but help is available.

“Receiving a renewal notice or hearing about the policy changes does not necessarily mean you are losing your coverage,” said Brisa G., Community Engagement Manager with CHPW.

Your health plan, community organizations, health care navigators, and local resources can guide you through the right steps to stay covered. They can also help you explore other coverage options if you no longer qualify for Apple Health.

“It’s important that you ask questions and seek assistance. There are resources available to help you understand your options and help you complete your renewal on time.”

Brisa G.
CHPW

If you have questions or need assistance updating your information, reach out to your health plan’s customer service team or visit Washington Healthplanfinder online.

CHPW Apple Health members can call Customer Service at 1-800-440-1561opens phone dialer, Monday through Friday, 8 a.m. – 5 p.m.
Members can also choose their preferred communication method with CHPW (email, text, or mail.) by filling out this online Member Communication form.

The bottom line: Changes can be stressful but you don’t have to figure this all out by yourself. Whether you’re unsure about eligibility, need help renewing, or just want someone to walk you through the next steps, know that support is just a phone call or click away.