Clark County Medicaid recipients urged to stay informed as new work requirements begin in January

With new Medicaid work requirements set to take effect in January, the Washington Health Care Authority is urging Clark County residents to stay alert, update their information and keep an eye out for important notices through mail or email that could affect their health coverage. At a Thursday community panel hosted by Columbia River Mental Health Services, Heather Chrzan, Medicaid eligibility policy manager for the Washington Health Care Authority, said adults on Apple Health must meet work requirements unless they have an exemption. A list of exemptions can be found on the Health Care Authority website. The requirements are part of a slew of cuts and changes to Medicaid as part of President Donald Trump’s “One Big Beautiful Bill Act,” also known as H.R. 1. The Congressional Budget Office estimates 21,654 people in Washington’s 3rd Congressional District could lose Medicaid coverage by 2034 due to H.R. 1. Nationally, H.R. 1 would reduce Medicaid enrollment by more than 11 million and increase the number of people without insurance by 7.5 million in 2034, according to an analysis from KFF, an independent public health nonprofit. Those estimates, however, do not account for Medicaid changes related to work requirements. New requirements Work requirements or an exemption must be met in the month before applying, or in any of the six months before renewing coverage. Work requirements are met when a person has at least $580 in monthly household income or an average of that amount over a six-month period for seasonal workers. Alternatively, adults can meet work requirements by enrolling in an educational program at least half-time or by participating in a work program, completing community service or a combination of work, community service, work program or educational program for at least 80 hours per month. “One good thing about the income threshold is that really a lot of our clients currently, from what we can see in our data systems, are earning at least that amount,” Chrzan said. “They may not see these questions because our systems say you’re meeting work requirements because you have that income. You don’t need to provide anything else.” Chrzan said a key takeaway for adults on Apple Health and community organizations is that for 2027, residents will be able to report their own work activity to meet requirements, rather than having to provide separate documentation. The Washington Health Care Authority is still working on a way to verify self-reporting beginning in 2028. “We hope to utilize our data systems to be able to verify that attestation before we ever reach out to a client and ask them to provide any proof,” Chrzan said. “We don’t quite know what proof looks like for certain activities for 2028. Definitely more information to come, but that is what we do know now.” In addition to work requirements, adults on Apple Health will need to renew coverage every six months. Christina Miller, who supports patients at Columbia River Mental Health Services who are applying for Apple Health, said completing a new H.R. 1 work requirements survey by the Washington Health Care Authority is a good first step for residents to assess their next plan of action. She also recommends looking at the Washington Healthplanfinder eligibility requirements. The Washington Healthplanfinder is a state-based health insurance marketplace compliant with the Affordable Care Act. “Get your information updated, get an account through Washington health finder or connect with somebody that can get you that,” Miller said. “The information is only as good as what’s listed with the state.” Concerns about changes Staff at local nonprofits and service providers who work with clients on Apple Health expressed concern about the state’s ability to process renewals under the new requirements. With renewals occurring every six months, their workload has doubled. They also worried that many would struggle to meet work requirements within the required time frame. About 11,000 refugees, asylum-seekers and other lawful immigrants in Washington have already lost coverage by Apple Health due to a provision in H.R. 1 which narrows the definition of a “qualified noncitizen” eligible for Medicaid. Daniel Smith, Columbia River Mental Health Services CEO, said he expects Clark County residents on Apple Health will struggle to navigate Medicaid cuts and changes because of added paperwork and deadlines. “There is enormous pressure on the nonprofit sectors and particularly those that are safety net providers,” Smith said. “Having said that, the real stress comes to the people who are going to be directly affected by losing insurance or being confused about insurance changes.” Lisa Aarseth, chief clinical officer at Columbia River Mental Health Services, encouraged patients to attend their scheduled health appointments, even if they are unsure whether they have lost Medicaid coverage. “This is a big change,” Aarseth said. “We just want to assure individuals to keep their appointments, continue to attend, even if you’re unsure about what’s happening with coverage or insurance. Bring your questions with you. Call the clinic.”

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