Washington Expects 250,000 to Lose Medicaid Under Work Rules
Washington's Health Care Authority estimates roughly 250,000 of the more than 600,000 Medicaid enrollees subject to new federal work requirements will lose coverage when the rules take effect in 2027. The requirements, created under federal legislation known as HR1, mandate that enrollees document 80 hours per month of work, volunteering, or school at renewal, or qualify for an exemption, with renewals now occurring every six months instead of annually. Exemptions cover pregnant people, caregivers, and those in addiction treatment, but CMS has told the state that a "medically frail" exemption cannot rely on diagnosis alone, leaving unclear what proof chronically ill enrollees like a Seattle man with Type 1 diabetes will need to submit. The state has spent $100 million and hired about 100 additional staff to automate renewals and limit coverage losses, while a state senator argues the rules will reduce long-term dependency on public benefits.