Governor Ferguson signs executive order to mitigate impacts of H.R. 1
State efforts so far have saved Apple Health coverage for hundreds of thousands of Washingtonians
 SEATTLE – Governor Bob Ferguson signed an executive order today to help mitigate the impacts in Washington state from H.R. 1, federal legislation gutting health care and food assistance nationwide.
President Donald Trump signed H.R. 1 more than a year ago, cutting more than $1.3 trillion in health care and food assistance nationwide. Many health care coverage impacts are coming in the next several months.
Washington is required to implement H.R. 1, and has already been forced to spend nearly $100 million to do so. If Washington state were to pay for everything H.R. 1 cuts, it would cost an estimated $3.2 billion per biennium.
Two major impacts are coming in the next several months:
- Starting Oct. 1, H.R. 1 drastically limits the Medicaid eligibility for lawfully present immigrants. Before the state took action, 14,000 lawful immigrants were set to lose their Apple Health coverage.
- Starting Jan. 1, more than 600,000 Washingtonians will be subject to work requirements for the first time in order to keep their Apple Health coverage. These individuals will also be required to reapply twice as frequently.
“In the richest country in the world, Donald Trump is kicking the most vulnerable people off their health coverage,” Governor Ferguson said. “The Big Bad Betrayal Bill is devastating to our health care system. But we are not powerless. I asked my team to find ways to blunt the impact of H.R. 1 on Washingtonians, and they delivered. Their work has preserved health care coverage for hundreds of thousands of Washingtonians. The work continues, and my executive order lays out our next steps.”
At a press conference in Seattle today, Governor Ferguson highlighted two major achievements: Saving Apple Health coverage for 3,000 Washington immigrants, and implementing an automated verification hub to help 400,000 Washingtonians keep their Apple Health coverage.
Photos from the event are available here. Video is available here.
He also highlighted that even with these accomplishments, at least 200,000 are projected to lose their Apple Health coverage by the end of 2027 as a direct result of H.R. 1.
Because of the long delay between passing the bill and many of the elements of the bill going into effect, too many people are unaware of what is coming, and what their options are.
The governor encouraged everyone with Apple Health to make sure their information is current, and to look out for communications from Apple Health. He asked Washingtonians to help spread the word, and help loved ones verify their information.
Protecting Apple Health coverage for lawfully present immigrants
Washington state is doing extensive outreach to immigrant communities with our health care navigators, the Office of Refugee and Immigrant Assistance and community partners, providers, and labor.
This team has helped people update their information and, in some cases, take steps to transition to an immigration status that will allow them to continue to qualify for Medicaid coverage.
Those efforts have helped 3,000 Washington immigrants keep their health care coverage.
Instead of 14,000 immigrants losing Apple Health on October 1, those efforts have brought that number down to 11,000.
Nation-leading verification hub protects Apple Health for 400,000 Washingtonians
Washington is leading the nation in building an automated verification hub.
Every additional form or documentation requirement creates another opportunity for someone to lose coverage, not because they are ineligible, but because the process is too difficult.
This hub will bring together data that is already available to automatically confirm eligibility, so people don’t have to submit new paperwork every six months.
Washington state expects this will help 400,000 people keep their Apple Health.
Executive order sets a path forward, impacts remain
Governor Ferguson signed an executive order laying out a path forward.
The order emphasizes Washington state will continue doing the work mentioned before, such as building our verification hub.
Next, it establishes a formal committee: The H.R. 1 Continuous Medicaid Response Committee.
The committee will be led by Washington’s health services agencies, in consultation with the Office of the Insurance Commissioner, Health Benefit Exchange and other agencies.
They will have a number of responsibilities, including:
- monitoring for impacts on Washingtonians and our healthcare system;
- coordinating responses to future changes;
- develop a proposal to create a Healthcare Access and Affordability Council, which will develop short-term and long-term strategies to help people keep their health care coverage, and control health care costs;
- and identifying barriers, coverage disruptions and opportunities for state action.
Governor Ferguson’s order also directs a coordinated statewide public awareness campaign, focused on getting the word out to all impacted Washingtonians.
The order directs the Department of Health to develop a data accountability system, to track who is losing coverage, and where there are gaps so the state can take additional action, and understand the true impact of H.R. 1 in our state.
Governor Ferguson’s order also directs DSHS to work with philanthropic organizations and other partners to expand the capacity and reach of the state.
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