OLYMPIA, WA (MyBellinghamNow.com) – Hundreds of thousands of Washingtonians could see changes to their Medicaid coverage as new federal requirements begin taking effect this fall.

Starting on Oct. 1, the Washington state Health Care Authority (HCA) says certain noncitizens will no longer be eligible for Medicaid, also known as Apple Health in Washington. Those include refugees, asylum seekers, conditional entrants, victims of trafficking and more.

Other changes taking effect on Jan. 1, 2027, will require adults with Apple Health to prove they work, train or take part in community engagement for 80 hours per month to remain eligible.

Future changes in October 2028 will charge enrolled adults up to $35 for some services.

Apple Health provides free or low-cost health coverage for nearly 2 million people in Washington. According to the HCA, about 33,000 adults in Whatcom County were eligible for Apple Health in July 2026.

The HCA estimates that between 200,000 and 320,000 Washingtonians will lose coverage because of cuts to federal funding.

The eligibility changes stem from Congress passing and President Trump signing the One Big Beautiful Bill Act, H.R.1., on July 4, 2025.