Health Care Changes for Immigrants in Washington
The federal One Big Beautiful Bill Act (“OBBBA”) changes eligibility standards for Medicaid, CHIP, Medicare, and the Affordable Care Act (ACA) Marketplace in ways that newly exclude many lawfully present immigrants who have previously received care from these programs.
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Only The Following People Will Be Able to Keep or Get Coverage
The following individuals will continue to qualify for health coverage under the new federal restrictions:
- U.S. Citizens including Naturalized Citizens
- Lawful Permanent Residents (Green Card Holders)
- Individuals with Cuban-Haitian Entrant Status
- Compact of Free Association (COFA) Migrants
This change applies to:
- Medicaid*
- CHIP*
- Medicare
- ACA Premium Tax Credits
Timeline of Health Coverage Changes for Immigrants
Federal policy changes are already affecting Medicare eligibility for immigrants who would have been newly eligible and will soon impact access to other programs for many immigrants in Washington.
The timeline below outlines when these restrictions take effect.
January 1, 2026
All lawfully present immigrants below the poverty line who are ineligible for Medicaid due to immigration status lose federal premium tax credits.
October 1, 2026
Medicaid and CHIP eligibility federal restrictions go into effect.
*Washington State will continue to cover children under age 19 and pregnancy-related Apple Health.
January 1, 2027
Lawfully present immigrants other than those listed above lose federal advance premium tax credits. Washingtonians up to 250% Federal Poverty Level continue to be eligible for Cascade Care Savings.
January4, 2027
Lawfully present immigrants other than those listed above who were already enrolled in Medicare will lose their eligibility.