Subject of Possible Rule Making: WAC 182-503-0535 Washington apple health—Citizenship and immigration status, and 182-507-0130 Refugee medical assistance (RMA); other related rules as appropriate.

Reasons Why Rules on this Subject may be Needed and What They Might Accomplish: Effective October 1, 2026, certain previously eligible legal immigrants will become ineligible for federally funded medical assistance. Specifically, the definition of qualified noncitizens will apply only to lawful permanent residents, Cuban/Haitian entrants, and Compact of Free Association migrants. The health care authority (agency) is amending its rules to comply with this change in federal law (42 U.S.C. 1396b(v)). During this review, the agency may identify additional related changes that improve clarity or update policy.

Other Federal and State Agencies that Regulate this Subject and the Process Coordinating the Rule with These Agencies: United States Department of Health and Human Services, Centers for Medicare and Medicaid Services.

Process for Developing New Rule: The agency welcomes the public to take part in developing this rule. If interested, contact the person identified below to receive an early rule draft to review. After the early review, the agency will send a notice of proposed rule making (CR-102) to everyone receiving this notice and anyone who requests a copy.

Interested parties can participate in the decision to adopt the new rule and formulation of the proposed rule before publication by contacting Brian Jensen, Rule-making Questions, P.O. Box 42716, Olympia, WA 98504-2716, phone 360-725-0815, fax 360-586-9727, telecommunication relay services (TRS) 711, email brian.jensen@hca.wa.gov, website www.hca.wa.gov/about-hca/rulemaking; or Giovanny Delgado, Program Questions, P.O. Box 42722, Olympia, WA 98504-2722, phone 360-725-1919, fax 360-586-9727, TRS 711, email Giovanny.delgado@hca.wa.gov, website www.hca.wa.gov/about-hca/rulemaking.