Thousands of King County residents could face changes to their health coverage beginning Oct. 1 as new federal Medicaid rules begin taking effect in Washington, followed in January by work requirements, more frequent eligibility renewals and shorter retroactive coverage periods for many adults enrolled in Apple Health.
The changes stem from H.R. 1, the federal law enacted in July 2025 that made significant changes to Medicaid and other health coverage programs. In Washington, the changes will be implemented in stages, beginning with new eligibility restrictions affecting some lawfully present noncitizen adults.
For health care providers and outreach officials, the concern extends beyond whether people technically qualify for coverage. They worry that people who lose insurance or have difficulty navigating the new requirements could delay routine and preventive care until their health problems become more serious…