Spokane families will be seeing significant changes in how they will qualify for and maintain their health coverage through Medicaid, or Washington’s Apple Health Program. These changes are a result of new federal legislation that was passed in July 2025, commonly known as H.R. 1. For people with IDD and their families, understanding these changes is important. The legislation introduces new work requirements and eligibility renewals that are more frequent.
However, not everyone receiving Apple Health will be subject to the new requirements. There are several exclusions for people with disabilities and caregivers.
The New Work Requirements
The new work requirements apply to Apple Health for Adults, serving eligible adults ages 19-64. Other Apple Health programs, such as coverage for children, pregnancy, and some disability-related categories, are not subject to the same new work requirements. Families should clarify which Apple Health program they receive, since individuals with disabilities may utilize several different Apple Health programs.
Under the new work requirements, some adults will need to show that they are working, going to school, participating in job training, volunteering, or doing another approved activity. The general requirement is 80 hours per month, though many people will not have to meet this requirement because they qualify for an exception.
One of the exceptions for the work requirement are people who are considered “medically frail.” This can include someone who has an intellectual, developmental, or physical disability that significantly affects daily living, a disabling mental health condition, substance use disorder, or a complex medical condition.
For 2027, the Washington Health Care Authority (HCA) says people will be allowed to report, or “self-attest,” that they meet the medically frail criteria.
The work requirements also include protections for caregivers, too. Some people who care for a child under age 14 or a person with a disability may not have to meet the work requirement. This is especially important information for Spokane families and kindred who’s caregiving responsibilities make it difficult to work outside the home.
Changes in Renewals
Beginning January 1, 2027, people enrolled in Apple Health for Adults will also be required to renew their coverage every six months instead of once a year. This requirement is separate from the new work requirements, so individuals who qualify for a work requirement exemption may still need to renew their coverage more frequently.
What Should Families Do?
Know your Apple Health program: find out if you receive Apple Health for Adults or another type of Medicaid plan.
Keep your contact information updated with the HCA so you don’t miss important notices or updates with your coverage.
Ask for help if you’re unsure: Washington Health Care Authority (HCA): 1-800-562-3022 can verify coverage and plan details.
Join The Arc of Spokane Parent Coalition to stay up to date on changes with healthcare access, services, and supports that our community relies on, and to share your voice with lawmakers!
Important Update: On October 29, 2026, a federal judge blocked the federal government's restrictive definition of who qualifies as "medically frail" under the new Medicaid work requirements. This ruling helps protect exemptions for people with disabilities and serious medical conditions. However, the ruling does not eliminate the new work requirements, which are still scheduled to begin January 1, 2027.
Source: https://www.hca.wa.gov/free-or-low-cost-health-care/changes-apple-health-medicaid