The Federal government has been working to limit who can receive public benefits like Medicaid (known as Apple Health in WA) through the passage of HR1 and other related policies. These impacts will roll out slowly, with significant changes to Medicaid starting in September 2026.

Medicaid impacts timeline

A timeline of impacts to Medicaid

“Public charge”: Starting Sep. 18, 2026

The Federal government has added Medicaid to the list of benefits considered “public charge.” This means that anyone applying for legal permanent residence could be disqualified if they have received Medicaid. This policy is meant to intimidate immigrants off benefits programs by threatening future citizenship opportunities. This rule change is being challenged in the courts, but leaves many immigrants in a difficult place before the courts issue a decision.

Medicaid coverage cuts for immigrants: Starting Oct. 1, 2026

Many lawfully present immigrants will lose access to Medicaid after October 2026. After this date, only citizens, green card holders, Cuban or Haitian entrants, and Compact of Free Association (COFA) migrants will be eligible. Healthcare coverage through Medicaid will no longer be available for immigrants with lawful status for humanitarian protections, including refugees, people granted asylum, and certain victims of domestic violence or sex or labor trafficking, among others living lawfully in the U.S.

Work requirements: Starting in 2027

In 2027, adults between 19-65 who receive full Medicaid coverage will have to either complete work requirements (WRs) or prove their eligibility for an exemption.

  • If you qualify to meet work requirements, you will need to show that you’re exempt, or that you work, volunteer, or participate in approved programs for the equivalent of 80 hours a month.
  • The following people do NOT have to do work requirements
    • pregnant/postpartum parents
    • foster youth under 19/former foster youth under 26
    • tribal members
    • medically frail patients
    • disabled veterans
    • those who already comply with SNAP/TANF WRs
    • caregivers to a dependent with a disability
    • people who are incarcerated or 90-days post-release