Washington’s Health Care Authority counted 602,927 adults in Apple Health for Adults in November 2025, and every one of them between 19 and 64 will face a work requirement unless an exemption applies. The rule comes from Trump’s 2025 law and applies to people who apply or renew from January 1, 2027. The authority’s H.R. 1 eligibility summary says nobody’s coverage changes before that person’s next renewal in 2027.
What the 602,927 figure covers
The figure is the authority’s enrollment count for the adult group in November 2025. It is a count of people on the program, not of people who will be cut off. The agency’s own data suggests that about 64 percent may be verified as working or qualify for an exemption.
That leaves a large middle. The authority found that 32 percent of the group has income on record and another 32 percent has an exemption. The remaining 36 percent of non-exempt adults have no income on record, so the state cannot confirm their work from its own files.
For those members the paperwork starts with the client. The authority says people can self-attest to income, employment or an exemption, and that earning the equivalent of 80 hours at the federal minimum wage in the prior month meets the test. Members who need to prove work must do so one month before their renewal date.
Each renewal sets its own start
Washington is not switching everyone on at once. The authority gives the example of a client whose next renewal is in June 2027: the work rules do not count toward that person’s eligibility until June. A member renewing in March feels it three months earlier.
The rule also arrives with other changes on January 1, 2027. The summary lists shorter certification periods, more frequent redeterminations, a shorter window for retroactive coverage, and more verification, including death and address checks. The authority is building a verification hub to launch by January 2027.
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New applicants face the same rule. Starting January 1, 2027, the authority says people applying for or renewing Apple Health for Adults must meet the work requirement or qualify for an exemption. For an applicant there is no old coverage to protect, so the proof of work or exemption has to be ready on the day the application goes in.
Community Health Plan of Washington, one of the state’s Apple Health plans, tells members that renewals will happen every six months from January 2027. It also cites a household income test of at least $580 a month, which is the same standard as 80 hours at the federal minimum wage of $7.25.
Who the state exempts
The exemption list is broad. It includes parents, guardians and caregivers, medically frail people and those with disabilities or serious health conditions, people in qualifying drug or alcohol treatment, former foster youth, veterans rated 100 percent disabled, people entitled to Medicare and people who are incarcerated.
Anyone already meeting work rules for food or cash assistance is also covered, and so are pregnant and postpartum American Indians and Alaska Natives and certain tribal populations. The authority adds that clients who miss the requirement may still qualify during a short-term hardship.
The authority plans to explain all of this through letters, a client webpage, text messages, videos and paid advertising, though the advertising depends on supplemental budget funding. Clients can sign up for updates through GovDelivery under the Apple Health general information topic.
How many could lose Apple Health?
Gov. Bob Ferguson’s office says at least 250,000 people could lose coverage over time, according to the plan’s explainer. Nearly 2 million Washingtonians rely on Apple Health overall, so the estimate covers a minority of all enrollees but a large share of the adult group.
An October 2025 presentation to the state Senate’s Ways & Means committee, prepared by the Health Care Authority and its partner agencies, went further. It said more than 620,000 adults would be at risk of losing or delaying coverage because of administrative red tape.
The same presentation said adults would pay up to $35 for many services under cost-sharing that begins October 1, 2028. Another change took effect earlier: eligibility for certain lawfully present non-citizens shifts on October 1, 2026, which it said could affect more than 30,000 people now enrolled.
Those numbers measure different things. The 602,927 is who is enrolled, the 36 percent is who the state cannot yet verify, the 250,000 is a governor’s office estimate of eventual losses, and the 620,000 is everyone exposed to paperwork risk. Only the first is a count.
The authority also says its rules are still being finalized with federal guidance and state rulemaking, which is why its summary describes most changes as taking effect at the client’s next renewal after implementation. Members should expect the exact notice wording and proof deadlines to arrive by letter and text.
The practical test comes at each client’s own renewal date. Keeping a phone number, address and email current, and knowing which exemption applies, is what lets the state’s data checks do the work before a request for proof ever goes out.
Does your Apple Health renewal fall before or after June 2027?
A renewal that lands in the first months of 2027 is the first to be tested, and a member who cannot show last month’s work or an exemption can lose Apple Health. The state says members who need to prove work must do so one month before the renewal date.
The SNAP & Medicaid Renewal Organizer covers the new Medicaid work requirement and who is exempt, plus a renewal and reporting calendar and a renewal document checklist. Its 51 state packs include Washington, so the proof-of-work month is marked ahead of the renewal.
Get the Apple Health renewal organizer with exemptions and a proof-of-work calendar →
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This article was produced with AI assistance and edited for accuracy against the sources linked above.
