WA challenges federal Medicaid barriers jeopardizing Washingtonians’ health coverage

On November 5, 2026, Washington Attorney General Nick Brown filed suit in the U.S. District Court for the District of Oregon against HHS, challenging federal Medicaid changes enacted in H.R. 1, the 2025 federal budget bill. The suit was joined by the attorneys general of Minnesota, New Mexico, and Oregon. Implementation of the challenged requirements is scheduled to begin in 2027. The challenged provisions impose community engagement and documentation requirements on Medicaid enrollees in the ACA Medicaid expansion population. Washington's program, Apple Health, covers more than 1.9 million residents, including 15% of adults and 36% of children in the state. The new requirements affect approximately 600,000 Washington residents enrolled through the ACA expansion. The Washington Health Care Authority estimates that at least 20% of the affected expansion members, approximately 120,000 people, stand to lose coverage under the new requirements. The complaint alleges that in states where comparable policies have been implemented, enrollees lost coverage not due to ineligibility but due to inability to comply with documentation burdens. The lawsuit alleges that Congress and the federal administration exceeded their constitutional authority in requiring states to implement these changes as a condition of Medicaid participation. The complaint specifically identifies rural counties as disproportionately affected, citing higher Medicaid utilization and unemployment rates, and further alleges the requirements risk closures of rural health facilities.