Washington Gov. Bob Ferguson is promising to protect Apple Health coverage for as many residents as possible as major Medicaid changes under H.R. 1 begin taking effect.
Ferguson made the comments while signing a new executive order to mitigate the federal law’s effects in Washington, where nearly 2 million people receive coverage through Apple Health. His criticism quickly drew pushback online, with commenters questioning government spending, eligibility and Washington’s own health care policies.
For context, President Donald Trump signed H.R. 1, commonly known as the One Big Beautiful Bill Act, into law on July 4, 2025. The sweeping tax and spending law includes significant changes to Medicaid eligibility, work requirements, renewals and federal health care funding.
You can hear him tell the audience, “The federal government’s changes are all designed for one purpose. It is thinly veiled to kick people off Medicaid. To make the system as difficult as possible to navigate.”
Among the changes, some lawfully present noncitizens will lose federal Medicaid eligibility beginning October 1. Starting January 1, 2027, many adults will also be required to work, train or participate in community engagement for 80 hours per month, with exceptions, while eligibility renewals will increase from once a year to every six months.
Ferguson’s statements direct several state agencies to find ways to maintain healthcare coverage and reduce the number of people who lose it as the requirements take effect. His office estimates that if Washington attempted to replace everything H.R. 1 cuts, it would cost the state approximately $3.2 billion every two years. The governor’s office says the state has already been forced to spend nearly $100 million implementing the federal law.
Washington officials nevertheless expect substantial disruption as the changes roll out. In addition to the October immigration eligibility changes, Apple Health adults will face new work or community engagement requirements, more frequent eligibility renewals and address verification beginning in 2027. Other provisions, including new Medicaid cost-sharing requirements, take effect later.
Critics Push Back on Ferguson’s Medicaid Warning
Ferguson wrote in the caption to the post itself, “It’s morally bankrupt what Congress and President Trump did to kick people off Medicaid. What we have to do is get to work — we’re saving Apple Health coverage for hundreds of thousands of Washingtonians.”
Some commenters rejected Ferguson’s characterization of the issue and instead focused on taxpayer costs. One person commented, “The moral bankruptcy occurs when the government steals our hard earned money to give it to people that don’t need it. Get a job.”
Immigration also dominated many responses, with commenters questioning whether taxpayer-funded health coverage should extend to people without legal immigration status.
Washington does provide Apple Health Expansion coverage to qualifying adults who cannot receive other Apple Health coverage because of their immigration status, including undocumented residents. However, that program is state-funded rather than traditional federally funded Medicaid, has income requirements and is subject to an enrollment cap. The state says the program has already reached that cap and is currently closed to new enrollment.
The immigration-related changes Ferguson is warning about are broader than Washington’s coverage for undocumented residents. Beginning October 1, H.R. 1 also narrows federal Medicaid eligibility for several groups of lawfully present immigrants, including refugees, asylees, humanitarian parolees and trafficking victims, according to the Washington Health Care Authority.
Ferguson’s executive order cannot stop the federal changes, but it directs state agencies to find ways to keep as many Washingtonians covered as possible. With the first major eligibility changes arriving October 1, the fight over who should qualify for coverage, and how much Washington should spend protecting it, is far from over.
