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Apple Health changes for some noncitizens begin October 1

September 24, 2026

  • Announcements
  • Health
Doctor holds patient’s hand

OLYMPIA – Starting October 1, 2026, some noncitizens will no longer qualify for full-scope Apple Health, Washington’s Medicaid program.

These changes are the result of House Resolution One (H.R.1), the federal budget law passed in summer 2025.

If you or a family member is affected, there are still health coverage and health care options available. See below for information about who is affected, what services remain available, and where to get help.

Who will remain eligible for full-scope Apple Health?

According to the Washington State Health Care Authority (HCA), beginning October 1, 2026, federal law limits full-scope Apple Health eligibility to certain immigration statuses.

People who remain eligible include:

  • U.S. citizens and nationals
  • Lawful permanent residents (LPRs) who have met the federal five-year waiting period (“five-year bar”) or are exempt from it
  • Compact of Free Association (COFA) islanders
  • Cuban and Haitian entrants

Who will no longer qualify based on their current immigration status?

People in the following immigration categories will no longer be eligible for full-scope Apple Health after September 30, 2026, unless they have another immigration status that remains eligible under the new rules:

  • Asylees
  • Conditional entrants
  • Refugees
  • Individuals for whom deportation or removal has been withheld
  • Victims of trafficking
  • Violence Against Women Act (VAWA) self-petitioners
  • Parolees, including:
    • Individuals paroled as part of the Afghan Allies Protection Act of 2006.
    • Afghans granted humanitarian parole between July 31, 2021 and September 30, 2023.
    • Ukrainians granted humanitarian parole between February 24, 2022 and September 30, 2024.

If you belong to these groups and do not hold Lawful Permanent Residency status, are not a COFA migrant or a Cuban/Haitian entrant, there are still options for you to get support with health insurance and health care costs. 

Not sure whether the changes apply to you?

HCA has published a detailed H.R. 1 Noncitizen Fact Sheet explaining the changes, eligibility rules, and available programs.

Fact sheet languages:

Apple Health services for individuals losing coverage

Apple Health for Kids is available regardless of immigration status.

Children in your household may still qualify even if an adult family member loses Apple Health coverage.

Other Apple Health programs

Adults who lose full-scope Apple Health may still qualify for certain state-funded programs if they meet the program’s eligibility and income requirements:

  • Apple Health for Pregnant individuals
  • After-Pregnancy Coverage (APC)
  • Apple Health Expansion (AHE)
  • Family Planning Only (FPO)
  • Medical Care Services (MCS)

Additionally, people experiencing a medical emergency, on dialysis or a cancer treatment plan may qualify for Apple Health Emergency Medical (AEM).

Need help applying?

To apply for these state-funded programs call the Health Care Authority (HCA) 1-800-562-3022 ext. 12533 (translation services available).

Free and reduced-cost health care is still available

Northwest Health Law Advocates (NoHLA) put together a list of free and reduced health care resources including:

  • Charity Care at Hospitals
    • According to the Attorney General’s estimate, half of all Washingtonians can get free or discounted care at hospitals.
  • Community Health Centers
    • Community health centers can provide free or low-cost care, with fees that may be based on your income.
  • Cascade Care Savings
    • Under this program, Washington can provide up to $250 each month to support with health insurance premiums
  • ArrayRx Card
    • Free card can help you save on certain prescriptions and over-the-counter medications.
  • Medical Condition-Specific Support
    • Washington has programs for people with cancer, kidney disease, and those who are HIV +.
  • Free Dental Referrals

For the complete list of resources and details about how to access them, go to NoHLA’s website:

More Apple Health changes are coming in 2027

The October 2026 changes are only part of a larger set of changes to Apple Health resulting from H.R. 1.

The Health Care Authority has published a timeline covering implementation from 2025 through 2029.

January 1, 2027: Apple Health work requirements begin

Beginning January 1, 2027, certain adults ages 19–64 enrolled in Apple Health will have to meet new work-related requirements.

There are exemptions for certain groups, including:

  • Pregnant and postpartum individuals
  • American Indian/Alaska Native (AI/AN) people and certain Tribal populations
  • Parents, caretakers, and guardians of a child under age 14
  • Other people who meet specified exemption criteria

To find our if work requirements apply to you, use HCA’s screener.

HCA provides information about the requirements, exemptions, and how to report eligibility: Apple Health work requirements. Fact sheets are available in 19 different languages.

Renewals will occur more frequently

Beginning in January 2027, working-age Apple Health enrollees will need to renew and confirm their eligibility every six months, rather than annually.

Official information and help

Washington Health Care Authority (HCA)

For the most current information about Apple Health changes:

Northwest Health Law Advocates (NoHLA)

For information specifically focused on immigrant access to health care:

Office of Refugee and Immigrant Assistance

  • Refugee Health Promotion and Health Navigation Services: ORIA partners with community-based organizations, healthcare providers, behavioral healthcare providers and local health departments to provide health education classes, medical and mental health navigation, and peer support groups. You can view a list of refugee health promotion service providers on ORIA’s interactive resource tool.
  • Refugees, asylees and certain other immigrants might be able to maintain or regain eligibility for federal public benefit programs like Medicaid by becoming lawful permanent residents (getting a green card). ORIA partners with organizations that can help immigrants become lawful permanent residents, if they are eligible.

Please contact ORIA at ORIAinfo@dshs.wa.gov with questions.

Learn more: