Description
HCA is updating this definition to match the definition recently codified in WAC 182-538D-0200 under WSR 25-22-061. This will help ensure consistency across HCA rule chapters.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Expedited Adoption (CR105)

Description
The authority is reviewing multiple sections within Chapters 182-30 and 182-31 WAC that may require SEB Board policy resolutions to support the SEBB Program.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Description
The authority is reviewing multiple sections within Chapters 182-30, 182-31, and 182-32 WAC to support the SEBB Program.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Description
The authority is reviewing multiple sections within Chapters 182-08 and 182-12 WAC that may require PEB Board policy resolutions to support the PEBB Program.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Description
The authority is reviewing multiple sections within Chapters 182-08, 182-12, and 182-16 WAC to support the PEBB Program.

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)

Supporting clients with changes to Apple Health

This page shares information for stakeholders to support Apple Health (Medicaid) clients preparing for and navigating upcoming changes to their health coverage.

H.R. 1 Impacts stakeholder webinar

Join us for the first H.R. 1 Impact stakeholder webinar.
Date: February 26
Time: 12:30 - 1:30 p.m.
Register for the webinar

Background

Federal changes to Medicaid—known as H.R. 1 (the One Big Beautiful Bill Act)— were passed by Congress and signed into law. These changes will affect Medicaid programs nationwide over several years.

The Health Care Authority’s (HCA) top priority is to implement new federal requirements in ways that minimize coverage loss and reduce client burden. Most eligibility-related changes will not happen right away. Based on federal timelines and available state options, major changes are expected to roll out gradually, pending guidance from the Centers for Medicare & Medicaid Services (CMS).

Who may be impacted

In Washington, Apple Health provides free or low-cost health coverage to nearly 2 million people, including children, adults, pregnant individuals, older adults, and people with disabilities.

Most of the changes related to eligibility and renewals will impact adults ages 19–64 enrolled in Apple Health for Adults. Other provisions may affect specific populations or providers over time.

Expanded changes and timing

Changes will happen slowly over several years. They will not happen all at once. We will share new information when we get it.

Change Start date
Changes to eligibility for refugee, asylee, and other noncitizen adults. October 1, 2026
To remain eligible, people enrolled in Apple Health for Adults will be required to work, train, or do community engagement 80 hours per month (with some exceptions). January 1, 2027
People enrolled in Apple Health for Adults will be required to renew their coverage every six months instead of twelve months. January 1, 2027
Retroactive coverage will be shortened from three months to one month for Apple Health for Adults and shortened to two months for all other Apple Health programs. January 1, 2027
People enrolled in Apple Health for Adults will have to pay cost-sharing up to $35 for many services. This does not include primary care, behavioral health, emergency services, and services given in certain rural settings. October 1, 2028

How you can help clients

Stakeholders play a critical role in helping clients stay covered and informed. You can support clients by:

  • Sharing clear, accurate information using HCA-approved resources and messaging.
  • Directing clients to resources when they need assistance with renewals, questions, or language access.

Learn more about the different types of help available:

Tools and resources

We will continue adding materials as they become available.

Materials

Videos

Toolkits

Need language assistance?

Language assistance services are available free of charge, including direct services by bilingual employers, interpreter services, and translation of printed materials. Visit our language access webpage to learn how to access language assistance.

00462: ProviderOne outage planned for Saturday, January 24, 2026
Discovery log number
00462
Discovery description

The ProviderOne system will be unavailable from 4:30 a.m. until 2:30 p.m. on Saturday, January 24, 2026 (10 hours) due to scheduled maintenance.

This outage does not affect the Pharmacy POS

Pharmacies will still be able to submit claims for processing and faxes can be sent during the outage. Faxes will be processed after the outage is complete.

Date reported
ETA
Provider impact
All Providers
Workaround
Please report any issues to: mmishelp@hca.wa.gov.
Description
The agency is amending chapter 182-70 WAC to remove use of the term “proprietary financial information” and to add the provision that the agency may act as the lead organization to coordinate and manage the all payer health care claims database. These amendments are intended to comply with changes to the enabling legislation (chapter 43.371 RCW) made during the 2025 legislative session (Chapter 305, Laws of 2025 (EHB 1382)).

Agency contacts

Rulemaking contact
Program contact
Rulemaking status history

Preproposal (CR101)