In 2019, Washington State passed HB 1199, strengthening access to the Apple Health for Workers with Disabilities (HWD) program. The law clarified that eligibility for the program could not be denied based on income or age, reinforcing its role as a Medicaid buy-in option for working individuals with disabilities. While participants may pay premiums based on income, the program itself is designed to allow people to maintain health coverage while working, without being excluded for earning more or getting older.

The change addressed a long-standing tension between employment and access to healthcare. For many individuals with disabilities, earning more income could historically put essential health coverage at risk. By reinforcing that eligibility is not tied to income limits or age restrictions, the law supports greater economic participation and stability. At the same time, the program still requires individuals to meet disability criteria and maintain employment, and premiums can be a factor for some participants. This moment reflects a broader effort to reduce disincentives to work while maintaining access to critical health services.