On July 4th, 2025, the Federal Administration signed The One Big Beautiful Bill Act (OBBBA), and as Medicaid and Washington State Apple Health statutory changes begin to roll out, SWACH is developing a response strategy that will span across Clark, Klickitat and Skamania counties to ensure people have clear information and know where to turn for help.
The Bill drastically changes eligibility for specific populations, adds work requirements, and now requires adult enrollees renew coverage every 6 months. For more details on what to expect, see Washington State’s Health Care Authority list of all upcoming Apple Health changes and key dates, here.
For SWACH, responding to those changes means building on one of the organization’s longstanding roles in Southwest Washington: bringing people and organizations together.
“I would say that SWACH is leveraging a lot of our existing infrastructure to support this response,” said Mercedes Zahler, SWACH’s HealthConnect Community Engagement Manager. “Probably [SWACH’s] biggest role [is] being the connector and convener of partners in these different spaces.”
SWACH is in the early stages of developing its response strategy, but our first priority is identifying where resources already exist, where gaps remain and how stronger connections among a network of organizations could help people maintain their Apple Health coverage. .
Helping people understand what is coming
One of the most immediate concerns SWACH is hearing from partners is that many community members may not yet understand how the changes could affect them.
“A lot of folks are really concerned that community members don’t know what’s coming, and they’re not preparing for how they themselves or their families will be impacted,” Zahler said.
Partners have also raised concerns about the practical realities of the new work requirements. Beginning in 2027, certain adults may be required to demonstrate qualifying activities or meet an exemption. Specific rules, timelines and documentation requirements should be confirmed with current state guidance.
That creates questions beyond simply explaining the new policy. Community members will need accessible information about qualifying opportunities, help navigating and understanding exemptions, and a trusted place to turn when someone needs assistance with their coverage.
SWACH is exploring how its existing partnerships can help connect people with workforce, volunteer and other community resource opportunities without duplicating work already happening elsewhere in our region.
Strengthening navigation and support
Another major concern is whether there will be enough enrollment and navigation assistance available as more people need help understanding their eligibility, completing renewals or getting back onto coverage.
Apple Health Navigator assistance in Southwest Washington is already limited, making it especially important to look at how our existing partner organizations can be leveraged to expand community member access to navigator assistance.
“We know a lot of people are going to [lose] coverage, so being able [maintain] coverage is going to be essential,” she said.
SWACH is also working to empower Community-Based Workers, health care providers and other frontline partners with training, referral pathways, and reliable information so they are better prepared when community members come to them with questions.
A trusted source for current information
Because state and federal guidance continues to evolve, providing timely and accurate information is another central part of SWACH’s response.
SWACH has launched an Apple Health changes webpage with current information, steps community members can take and links to official resources. Additional materials and resources for partners are also being developed and shared as information becomes available.
“We’re a trusted source of information,” Zahler said. “People know that they can come to our website, they can come to our staff and they can get accurate [information].”
Maintaining that trust comes with responsibility.
“People are looking to us already as the experts,” she said. “We have a lot of trust in the community, and that’s something important we continue to uphold.”
Part of that responsibility, Zahler said, is helping reduce uncertainty by sharing what is known while being clear when information is still developing.
“A lot of people are concerned right now, rightfully so, and are feeling a lot of strain,” she said. “I think we’re trying to reduce that burden by providing as real and up-to-date information as possible.”
A regional response will take regional partners
The vast scope of the changes means no single organization can address every need.
“One of the things I think we learned really quickly [convening a taskforce] is that there are a lot of arms to these changes,” Zahler said. “Even as an organization with broad reach and broad scope, we don’t have arms in all of the areas that we would need to have a really large impact.”
That makes coordination across the region particularly important. SWACH’s role will include convening partners to share information, identify service gaps, coordinate outreach and referrals, and align their efforts into a broader, more coordinated regional response.
Zahler described the goal as helping organizations see where they fit into the larger picture rather than having individual efforts operating separately from one another.
What would a successful response look like?
SWACH recognizes that it will not be possible to prevent every coverage loss associated with the changes.
For Zahler, success means reducing preventable coverage losses wherever possible.
“We know that we aren’t going to prevent every single person from losing coverage,” she said. “But if we can impact the number or the percentage of people that would lose coverage, that would be a really successful response.”
The response will continue to evolve as the implementation guidance becomes clearer, changes take effect and SWACH learns more from community members and partners about where additional support is needed.
Zahler said the strength of the response will ultimately depend on people and organizations working together.
“It’s going to take the whole village here to make it happen.”
Learn more about upcoming Apple Health changes and find current resources at southwestach.org/apple-health.