(The Center Square) – As Washington state grapples with a potential fiscal crisis by 2027, the Legislature this session allocated $150 million to fund a Medicaid-style program offering healthcare to illegal aliens.
It’s a spending discretion that one lawmaker is criticizing given that the state has chronically undercompensated medical providers of Medicaid patients, while a top ranking legislator argues expanded access to healthcare avoids overwhelming emergency services and facilities.
“We should be taking care of the people who are here legally,” Rep. Joe Schmick, R-Colfax, told The Center Square. “If we’re going to spend any more money in Medicaid, how come we don’t pay providers? If we’re going to invest more money, we should have paid the providers to take care of the people here.”
Created through various legislative appropriations in 2022 and 2023, the Apple Health Expansion program provides Medicaid-equivalent coverage for illegal aliens who are 19 and older and with incomes up to 138% of the Federal Poverty Level. The program opened for participants on June 20, 2024, with a maximum allowance of 13,000 enrollees. That limit was met within 48 hours of the program launching, with 17,000 on the waiting list, according to the Health Care Authority.
During this year’s session, Rep. My-Linh Thai, D-Bellevue, introduced House Bill 1482 early in the session that would have opened the program to all immigrants who meet the income eligibility guidelines and other requirements. The bill would have also had the state “establish and maintain a culturally and geographically diverse and linguistically appropriate immigrant health coverage outreach and education campaign, including direct support to community-based partners.”
However, the bill did not receive a public hearing in the House Health Care & Wellness Committee.
When The Center Square reached out to Health Care & Wellness Chair Dan Bronoske, D-Lakewood, for comment on Apple Health Expansion and HB 1482, he wrote in an email that his priority “continues to be increasing access to care and reducing costs for delivering care.”
“I believe it is good public policy for the people of the state of Washington to be covered and insured, so that they can get checkups and access care as soon as possible when they are sick,” he added. “Otherwise, people will delay seeking care and wait until their illnesses are so bad they require trips to the emergency rooms at our local hospitals. As a firefighter, I see this first-hand. This drives up costs for all us, the return on investment for health care spending is much higher when patients can address ailments like hypertension, diabetes, and get screened for cancer sooner rather than later.”
Schmick, who is the ranking minority member of Health Care & Wellness, said that “we need to pay for our citizens, those who are here legally, before we expand that pot of money or spread the peanut butter even thinner.”
Washington Policy Center’s Center for Health Care Director Elizabeth New told The Center Square that the Legislature didn’t expand the program this session because there was “no money to do so.” A The Center Square investigation published Monday shows that the Legislature’s $9 billion tax increases are a record, but the state still faces a budget shortfall. The latest forecast shows that the state will have just a $2 million funding balance by 2027 and a $400 million fiscal deficit by 2028, assuming no spending changes are made.
However, New added that “I’m sure they’ll try to increase it again.”
The Temporary Community Engagement Advisory Committee is a collaboration between HCA and the Department of Social and Health Services and intended to “be a safe space for community members to receive information about, and provide input related to the implementation of the Apple Health Expansion and the Qualified Health Plan Expansion programs.”
The Center Square reached out to Thai regarding whether she intends to reintroduce HB 1482 next session, and if so, what potential revenue sources might be proposed to cover it, but did not receive a response.
