Washington

Washington Medicaid and the new work rules

Apple Health for Adults (the ACA expansion group, 138% FPL) is run by Washington State Health Care Authority (HCA), in coordination with the Department of Social and Health Services (DSHS) for Classic Medicaid and long-term care, and the Washington Health Benefit Exchange for Washington Healthplanfinder enrollment. Washington expanded Medicaid on January 1, 2014, which is why the new federal work requirement reaches this state — and why what you do before January 1, 2027 matters.

Work rules start January 1, 2027 Medicaid expanded 1,988,750 enrolled 602,000 in the expansion group

Start here

From January 1, 2027, most adults have to show 80 hours a month

The requirement applies to adults aged 19 to 64 covered through Medicaid expansion — around 602,000 people in Washington. It is not only about paid work: study, job training, volunteering and a mix of them all count , and earning at least $580 a month satisfies it on its own.

If your hours swing from month to month, say so. The rule is written per month, which is the wrong shape for farm and fishing work, construction, tourism and seasonal retail — a good month and a dead month average out to a living, but the dead month is the one that fails. Federal law has a provision for exactly this: a seasonal worker can satisfy the requirement using their average monthly income over the previous six months instead of hours worked in the month being checked. It is at 42 CFR 435.552(a)(7), and the law defines who counts as seasonal by pointing at the tax code rather than listing jobs, so do not decide for yourself that it misses you. If your work is seasonal or your hours are irregular, tell the state that when you report, and ask for the six-month average to be used.

2026-06-01 · already happened

CMS published the interim final rule implementing the federal work requirement and its exemptions

2026-10-01 · already happened

Separate federal noncitizen eligibility restrictions (H.R.1 §71109) take effect for Apple Health, narrowing who counts as a 'qualified noncitizen'

2027-01-01

The 80-hour-a-month work requirement and the move to six-month renewals take effect for the Apple Health for Adults expansion group

You do not have to prove anything if any of these describe you

Exemptions are meant to be applied by the state automatically from records it already holds, but records are imperfect. If one of these fits you and you still get asked to report hours, say so and ask them to check — don't assume the notice is right.

Parents or caretakers of a child age 13 or younger, or of someone with a disability

Pregnant, or receiving postpartum coverage

Medically frail, or living with a serious or complex medical condition

Veterans with a VA total disability rating

American Indian or Alaska Native

In treatment for drug or alcohol use disorder

Already meeting SNAP or TANF work requirements

Recently released from incarceration

Income limits

What you can earn and still qualify

Monthly income, before tax, for the whole household. These are the state's own published figures, which is what its caseworkers actually apply. If you are close to a line, apply anyway — some income does not count, and only the agency can run the calculation for your situation.

Adults 19 to 64138% of the poverty line

1 person: $1,835
2 people: $2,490
3 people: $3,142
4 people: $3,795
5 people: $4,449
6 people: $5,102
7 people: $5,755

Parents and caretakers138% of the poverty line

1 person: $1,835
2 people: $2,490
3 people: $3,142
4 people: $3,795
5 people: $4,449
6 people: $5,102
7 people: $5,755

Pregnant215% of the poverty line

1 person: $2,860
2 people: $3,879
3 people: $4,896
4 people: $5,913
5 people: $6,932
6 people: $7,949

Source: Washington Apple Health Income and Resource Standards, Washington State Health Care Authority, effective July 1, 2026 (hca.wa.gov/assets/free-or-low-cost/income-standards.pdf); FPL-indexed figures update each April 1 and were last set April 1, 2026. A note on precision: Washington's income-standards table also publishes a much lower 'Family (N01)' category — $511/month for one person up to $1,471/month for a household of seven — that looks like a parent/caretaker income limit but is actually a legacy, non-FPL-indexed standard tied to an older cash-assistance-linked pathway. We publish the state figure.

January 1, 2027

Two other changes land on the same day

Renewals get more frequent, and back-dated coverage gets shorter.

Renewals every six months Starting January 1, 2027, adults covered through Apple Health for Adults move from annual to six-month eligibility renewals — twice as many paperwork deadlines each year.

Back-dated coverage is changing on January 1 One month for adults in the Apple Health for Adults expansion group; two months for children, people 65 and older, and people with disabilities. If you have unpaid medical bills, applying sooner covers more of them.

P.L. 119-21 §71112, amending 42 U.S.C. §1396a(a)(34). Applies to applications submitted on or after January 1, 2027.

Do this now

Update your address and phone number first. Everything about the new rules arrives by mail, and a stale address is the most common reason people lose coverage they are still entitled to. Then check whether an exemption applies to you.

Apply, renew or update details Washington Healthplanfinder Free, and open all year Talk to a person 1-800-562-3022 HCA Medical Assistance Customer Service Center (MACSC) / Medicaid Eligibility Determination Services (MEDS) — for current Apple Health clients, eligibility questions, and appeals Washington Healthplanfinder 1-855-923-4633 to apply for or enroll in Apple Health or a marketplace plan DSHS Customer Service Contact Center 1-877-501-2233 for Classic Medicaid (age 65+, blind, or disabled) and Medicare Savings Program applications

About the phone numbers: HCA's client line (1-800-562-3022) keeps business hours of Monday–Friday, 7 a.m. to 5 p.m. Pacific, and is closed on state holidays. Washington Healthplanfinder extends its hours during open enrollment (November 1, 2025 – January 31, 2026).

Deaf, hard of hearing or speech-impaired: 711 (Washington Relay); Healthplanfinder TTY is 1-855-627-9604.

EnglishSpanish

Washington Healthplanfinder and the Health Care Authority offer free interpreter help in more than 200 languages by phone. If English is not your first language, tell the person who answers which language you speak when you call 1-855-923-4633 (Washington Healthplanfinder) or 1-800-562-3022 (Health Care Authority) and ask for an interpreter before you start describing your situation — you do not need to arrange your own interpreter, and there is no charge for this help.

If a letter arrives

Most people who lose coverage lose it over paperwork, not eligibility

Nationally, most people who lose Medicaid lose it over paperwork rather than because they stopped qualifying. From January 1, 2027 that matters more, not less.

Washington State Health Care Authority (HCA), in coordination with the Department of Social and Health Services (DSHS) for Classic Medicaid and long-term care, and the Washington Health Benefit Exchange for Washington Healthplanfinder enrollment · Notice of action

NOTICE OF ELIGIBILITY DETERMINATION

Case number: ███████
Date of this notice: 1January 12, 2027

Our records do not show that you met the community engagement requirement for the reporting period.

2If you believe this is incorrect, or if an exemption applies to you, contact us on or before February 11, 2027.

3Coverage for other members of your household is not affected by this notice.

The clock starts on this date. Not the day it reached you. Assume you have less time than it feels like.

"Our records do not show" is not the same as "you did not".The state is matching against databases that are often out of date. If you worked those hours, or an exemption fits you, say so — call 1-800-562-3022.

Your children's coverage is separate. The work requirement does not apply to them. A notice about you does not end their coverage.

You can ask for a fair hearing. It's free, you don't need a lawyer, and asking can keep your coverage running while it's reviewed.

Know your state

What the federal data says about coverage here

Public federal data describes how each state runs its program. Almost all of it is written for policy analysts. Here is what those numbers mean if you are the person enrolled.

How care is delivered

Managed care

Coverage here runs through private health plans rather than the state paying providers directly. You pick a plan, and your plan decides your network.

Check your doctor is in the plan before you choose it.

Common questions

Questions people ask about this

Do the new Medicaid work rules apply to me in Washington?

They apply to adults aged 19 to 64 who are covered through Medicaid expansion — about 602,000 people in Washington. Children, people over 65, and most people covered on grounds of disability or pregnancy are not in that group. There is also a long list of exemptions.

How many hours a month do I have to work?

80 hours a month. Work is not the only way to meet it — study, job training, volunteering and a combination of these count too, and earning at least $580 a month also satisfies it.

Who is exempt from the work requirement in Washington?

Exemptions include: Parents or caretakers of a child age 13 or younger, or of someone with a disability; Pregnant, or receiving postpartum coverage; Medically frail, or living with a serious or complex medical condition; Veterans with a VA total disability rating; American Indian or Alaska Native; In treatment for drug or alcohol use disorder; Already meeting SNAP or TANF work requirements; Recently released from incarceration.

When do the Washington work rules start?

January 1, 2027. Starting January 1, 2027, adults covered through Apple Health for Adults move from annual to six-month eligibility renewals — twice as many paperwork deadlines each year. Keeping your address and phone number current with the state is the single most important thing to do before then, because everything arrives by mail.

What is the income limit for Washington Medicaid?

For adults 19 to 64, about $1,835 a month for one person and $5,755 for a household of 7.

How do I apply for Apple Health for Adults (the ACA expansion group, 138% FPL)?

Online at Washington Healthplanfinder, or by phone on 1-800-562-3022. It is free and there is no open-enrollment window — you can apply at any time of year.

How often do I have to renew Washington Medicaid?

Adults covered through Medicaid expansion move from a yearly renewal to one every six months starting with renewals due on or after January 1, 2027. Children, people over 65 and most people covered on grounds of disability stay on yearly renewals. Keep your address and phone number current so the renewal notice reaches you, and answer it before the date on the letter — most people who lose coverage lose it over paperwork.

Other states

Guides for neighboring states

The rules change completely at the state line. If you moved recently, or you're helping family somewhere else, start with their state rather than this one.

IdahoThe new work rules OregonThe new work rules

See all 50 states and Washington, D.C. on the map →

Starting today, October 1, 2026, federal law narrows who counts as a 'qualified noncitizen' for Apple Health — most refugees, asylees, and trafficking survivors no longer qualify for ordinary Apple Health coverage.

If this affects you, ask about Apple Health for Pregnant Individuals, Emergency Medical coverage, or a subsidized Washington Healthplanfinder plan; do not assume Apple Health Expansion is an automatic fallback, because it is currently closed to new enrollment after reaching its roughly 13,000-person cap. Call 1-800-562-3022 (Health Care Authority) or 1-855-923-4633 (Washington Healthplanfinder) to find out which coverage path is still open to you.

Updating your address takes two minutes and protects everything else. Do that first, then check the exemption list above.

Go to Washington Healthplanfinder →