On October 1, 2026, certain immigrant populations will no longer be eligible for Apple Health/Medicaid. Below is an overview of who is impacted, what services will be lost, and resources for both providers and patients.
Who is impacted?
- Refugees
- Asylees
- Victims of trafficking
- Parolees, including Afghan and Ukrainian
- Immigrants with another form of humanitarian protection
View more of the impacts here.
What else is important to know as a provider?
- Once a noncitizen in these categories adjusts to legal permanent resident (green card) status, they will again be eligible for Medicaid.
- With the loss of Medicaid comes impacts other than just losing health insurance. Patients will no longer be eligible for Medicaid-brokered taxi rides (Hopelink) to medical appointments, and those receiving in-home care services through Medicaid will lose this benefit as well.
- Certain patients may qualify for other health coverage types, including Emergency Medical (AEM). Children under age 19 and pregnant individuals will continue to be eligible for Medicaid regardless of immigration status.
- Further changes to Medicaid, including work requirements, start January 2027 and beyond.
What can I do now to support patients impacted by these changes (for those located in the King County area)?
- For those patients taking medications, try prescribing 90-day supplies
- Check alternative coverage programs to see if a patient will qualify (listed here under ‘Options for Individuals Losing Coverage’)
- Connect patients who qualify to Metro Access or Orca Lift as alternatives to Hopelink
- Help patients apply for financial aid at your clinic/medical center if available
Where can I find more information?
- UW Medicine has a What You Need to Know page on upcoming Medicaid changes
- Washington State Health Care Authority has put together a noncitizen fact sheet on these changes which is available in 15 languages
- DSHS has published this fact sheet on impacts to long-term care services for those losing Medicaid
- DSHS has published this fact sheet on maintaining/regaining eligibility for Medicaid
- H.R. 1 impacts to Apple Health Provider Toolkit includes an overview of changes, key messages, and coverage options
- The Washington State Hospital Association developed this useful timeline with upcoming Medicaid changes October 2026 and beyond