Biden Administration Approves Health Insurance for Illegal Immigrants in Washington State

A patient is transferred at Harborview Medical Center in Seattle, Wash., on May 6, 2020. Karen Ducey/Getty Images

The Biden administration has approved a waiver that will allow Washington state to offer health insurance to illegal immigrants.

The waiver, known as the “State Innovation Waiver” was submitted by the state in the spring and approved by the Department of Health and Human Services (HHS) and the Treasury Department on Dec. 9 under section 1332 of the Affordable Care Act (ACA), according to officials.

Washington requested the waiver in an effort to expand residents’ access to qualified health plans, stand-alone qualified dental plans, as well as the state affordability program regardless of their immigration status.

“The waiver will help Washington work towards its goals of improving health equity and reducing racial disparities by expanding access to coverage for the uninsured population through the state Exchange, all the while not increasing costs for those currently enrolled,” the departments said (pdf).

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According to the departments, the waiver is projected to meet certain requirements, including “providing coverage at least as comprehensive as coverage provided without the waiver,” “providing coverage and cost-sharing protections against excessive out-of-pocket spending that are at least as affordable as would be provided without the waiver,” and “providing coverage to at least a comparable number of people as would be provided without the waiver.”

Nurses in the COVID-19 unit of MedStar St. Mary's Hospital check the fit of protective equipment before entering a patient's room in Leonardtown, Md., March 24, 2020. Win McNamee/Getty Images

Insuring 105,000 Illegal Immigrants

The waiver will be effective from January 2024 through to December 2028, subject to the state accepting specific terms and conditions, and will allow roughly 105,000 uninsured illegal immigrants in the state to shop for insurance.

Washington state had already allocated $50 million for a state subsidy program called “Cascade Care Savings,” through which Washington residents with incomes below 250 percent of the federal poverty level and who get plans through Washington Healthplanfinder are offered premium subsidies.

With the approval of the new waiver, an additional $5 million in state funding will become available for these subsidies, starting in 2024, the departments said.

Washington Governor Jay Inslee, a Democrat, thanked the Biden administration for approving the request.

“We appreciate the federal government’s recognition of our effort to expand our successful state-based marketplace,” Gov. Inslee said in a statement. “This waiver is an important step toward providing affordable health insurance coverage for all Washingtonians. Access to health care not only helps strengthen families, it also improves our overall health care system and our state economy.”

Nurses converse before testing patients for coronavirus at the University of Washington Medical center in Seattle, Wash., on March 13, 2020.John Moore/Getty Images

Waiver Could Cost Taxpayers $1 Billion

The waiver for Washington state comes at a time when inflation has soared across the country, leaving American households and employers forking out more for health care, which is expected to increase 6.5 percent in 2023, according to Healthcare Finance.

Chris Pope, a senior fellow at the Manhattan Institute, told The Center Square that the health insurance waiver in Washington could cost taxpayers up to $1 billion per year, although the departments projected it would not raise the federal government’s deficit.

House Energy and Commerce Republican Leader Cathy McMorris Rodgers (R-Wash.) blasted the approval in a statement on Monday while taking aim at Gov. Inslee.

“At a time when President Biden’s inflation crisis is already increasing the financial burdens on health care providers and families in Eastern Washington and across the nation, health care premiums and costs are rising substantially. Rather than using federal funds to mitigate some of these costs for health care providers and Washingtonians, Governor Inslee would rather spend it on undocumented immigrants,” Rodgers said.

The Republican lawmaker added that the waiver is “a blatant misuse of taxpayer dollars,” and that Energy and Commerce Republicans will “continue to fight against dangerous policies that prioritize those who are breaking the law over law-abiding citizens.”

Washington is among 14 states to be granted a 1332 waiver. Others include Alaska, Colorado Georgia, New Hampshire, and Pennsylvania.