What will change in Medicaid look like?
This story appears in the January 2026 edition of The Washington Nurse.
A new federal budget law (H.R. 1, the “One Big Beautiful Bill Act”) will bring big shifts to Medicaid (Apple Health) and the individual health insurance market in Washington state. WSNA, AFT, and the American Nurses Association strongly opposed the bill’s severe cuts in Medicaid.
Now, we have a better understanding of what the sweeping changes will look like, thanks to a new fact sheet from the Washington State Health Care Authority (HCA), the state’s Medicaid agency. HCA administers Apple Health, sets policy, determines eligibility, and coordinates with federal partners.
The fact sheet looks at 10 areas that will be affected, including funding for noncitizens, work requirements, rural health funding, and frequency of eligibility redeterminations.
HCA reports that Apple Health provides health coverage to almost 2 million Washingtonians and that between 200,000 and 320,000 are projected to lose Medicaid coverage because of the federal budget bill.