Provide your feedback on the H.R.1 work requirement exemption

Washington State Health Care Authority sent this bulletin at 05/29/2026 03:00 PM PDT

May 29, 2026

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Provide your feedback on the H.R.1 work requirement exemption

The Health Care Authority (HCA) is looking for your feedback and review of the preliminary set of medical billing codes and conditions that will be used to identify and verify the Apple Health (Medicaid) for Adults medically frail exemption work requirements.

Background

Beginning January 1, 2027, most individuals applying for or renewing Apple Health for Adults will need to meet new Medicaid work requirements or meet the criteria for an exemption. The law specifies nine exemption categories, one of which is for individuals who are determined “medically frail.”

Under federal law, “medically frail” includes individuals with:

A substance use disorder (SUD)
A disabling mental disorder
A physical, intellectual or developmental disability that significantly impairs their ability to perform one more activity of daily living
A serious or complex medical condition
Blindness or disability

Medically frail code list

HCA developed a draft code set designed to identify and verify medically frail individuals enrolled in Apple Health for Adults. Use the link to review the list and instructions on submitting your feedback.

Comments are due by June 19, 2026.

View the medically frail code list

Submit your feedback

Submit your feedback to HCA by emailing HCA Apple Health Eligibility Policy with your comments.

H.R.1 resources

About the Health Care Authority (HCA)

Functioning as both the state's largest health care purchaser and its behavioral health authority, the Washington State Health Care Authority (HCA) is a leader in ensuring Washington residents have the opportunity to be as healthy as possible.

There are three pillars of our work: Apple Health (Medicaid); the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs; and behavioral health and recovery. Under these pillars, HCA purchases health care, including behavioral health treatment for more than 2.7 million Washington residents and provides behavioral health prevention, crisis, and recovery supports to all Washington residents.

Please do not reply directly to this message. For more information, visit the HCA website, where you'll also find contact information.

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Nondiscrimination

The Washington State Health Care Authority (HCA) complies with all applicable federal and Washington state civil rights laws and is committed to providing equal access to our services. Visit HCA’s website to view complete nondiscrimination statements.