This hub provides a centralized overview of major federal policy shifts impacting health care access and affordability. At the center is H.R. 1, otherwise known as the One Big Beautiful Bill Act (OBBBA)—a sweeping legislative package that introduces significant changes to eligibility, coverage, and funding across public health programs. But it is just one part of a broader transformation.
Alongside the bill, federal agencies are issuing new rules, and Congress is advancing parallel legislation that collectively reshape the health care landscape. These changes affect everything from immigrant eligibility to Medicaid access and consumer protections. Use this hub to stay informed, anticipate impacts, and support your community through the transition.
Timeline of Health Policy Changes
Track key dates and policy shifts from H.R. 1 and HHS’s June 2025 Marketplace Rule with a clear, structured timeline.
This practical roadmap helps policymakers, consumers, and advocates follow the phased rollout of changes impacting access, affordability, and care nationwide.
A Threat to Health Coverage in Washington
H.R. 1 (OBBBA), introduces sweeping changes that will make it harder for Washingtonians to get and keep health coverage through Medicaid (Apple Health), Medicare, and the Marketplace (WA Healthplanfinder).
Read NoHLA’s “Five Ways OBBBA Harms Health Care” to learn more.
Health Care Changes for Immigrants
What Immigrants in Washington Need to Know
Federal H.R. 1 (OBBBA) policy changes eligibility standards for Medicaid, CHIP, Medicare, and the Affordable Care Act (ACA) Marketplace—newly excluding many lawfully present immigrants who have previously received care through these programs.
Immigrant Impacts: Joint Summary with UW Latino Center for Health
UW's Latino Center for Health partnered with NoHLA to summarize H.R. 1/OBBBA impacts on Medicare, the Affordable Care Act (ACA) Marketplace, Medicaid and more for immigrants in Washington. Updated October 2025.
Training Resources
H.R. 1 Training for Service Providers
NoHLA maintains a presentation deck with key H.R. 1 health care information for Washington providers. We aim to keep the slides up-to-date so it can be a standing resource on state implementation.
Resources from HCA
Info and tools from the Washington State Health Care Authority (HCA).
Client-facing content includes:
- Timeline of changes and who they impact, with fact sheets in multiple languages
- Answers to frequently asked questions (FAQ)
- How to get updates
Stakeholder content includes:
- Timeline and announcements
- Guides and presentations
- Communications and social media toolkits
- Desk guide for legislative offices
