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Local advisory board warned HR1 will narrow Apple Health eligibility and increase renewals starting 2027
Summary
Spokane County BHASO staff briefed the advisory board on HR1 changes to Apple Health that create monthly address verifications, six-month redeterminations beginning January 2027, work/community engagement requirements for many adults, and reduced retroactive coverage — HCA estimates were cited showing hundreds of thousands may be affected.
Kayn Roy, a supervisor at the Spokane County Behavioral Health Administrative Services Organization (BHASO), told advisory board members that House Resolution 1 (HR1), dubbed the "one big beautiful bill act," was signed into law last year and will change who qualifies for Apple Health and how often eligibility is reviewed.
"Some of these provisions include increased redeterminations for eligibility, establishing work requirements, ... retroactive coverage periods, and verifications of death and address changes," Kayn said, noting many provisions begin in January 2027 and that some changes for lawfully present noncitizens begin as early as October of this year.
Board members pressed staff for clarity about practical effects. Kayn repeated HCA estimates that redeterminations could affect "just over 600,000 individuals" and that changes to the definition of lawfully present noncitizens could make "around 20,000 individuals will likely lose Medicaid or become ineligible." The presenter also said the adult certification period for Apple Health will move from annual to every six months and that retroactive coverage for adults will be cut from three months to one month.
Gail asked what "manual renewal" entails for people who do not have internet access; staff described options that remain under development, such as mailing hard-copy renewal materials or in-person assistance at exchange offices and using navigators and assisters by phone. Justin said the state and federal rules are still being worked out and that some exemptions will permit self-attestation.
Why it matters: The board was told HR1 will increase administrative work for both clients and providers and may raise the risk that eligible people temporarily lose coverage because of verification or renewal burdens. Staff urged outreach and described plans for HCA to publish guidance and for local implementation teams to develop customer-focused materials.
The board did not take formal action on HR1 at this meeting; staff said CMS will publish an interim final rule by June and HCA will finish Washington Administrative Codes before year-end, after which local processes and outreach will be refined.
