Guest Opinion

By Elizabeth Hovde

 Washington state taxpayers might be disappointed to learn that as inflation rises and daily household bills go up—and as the Legislature refuses to provide broad-based tax relief—the Inslee Administration is trying to obligate them to even more payments. And these aren’t just one-time payments, they would bring years of obligation.

The Inslee Administration just asked the federal government for permission to ignore the Affordable Care Act (ACA) requirement that tax-funded health benefits are for legal residents. If approved, subsidized health plans would be available to undocumented residents living in Washington state, as well.

“The state of Washington is pleased to submit this application for a Section 1332 State Innovation Waiver to help ensure all Washingtonians can obtain high-quality health coverage through hour state-based marketplace, Washington Healthplanfinder,” Gov. Jay Inslee writes in an application to expand coverage to more than 105,000 people.

If approved, the waiver will also allow individuals and families up to 250% of the federal poverty level and who are not getting any federal subsidies to take part in Cascade Care Savings, a new assistance program in our state, according to The Center Square.

Instead of pursuing this new obligation for taxpayers, with a debatable price tag, Gov. Inslee and other lawmakers should be working to make private insurance more affordable to purchase for illegal residents and everyone else, by eliminating state taxes and regulations.  One tax change alone could cut the cost of insurance by 2%.

Once undocumented residents can access a qualified health plan through Washington Healthplanfinder, they can then apply to take advantage of taxpayer subsidies, if income eligible. Washingtonians would pick up the tab.

 The Congressional Budget Office estimates ACA’s subsidy costs about $6,000 per enrollee. Multiplied by 105,000 new enrollees, this could add more than $600 million to state taxpayers each year.   

Chris Pope, a senior fellow at the Manhattan Institute, told The Center Square he believes the “per capita amount would probably be higher” in Washington state. He estimated the final price tag would be around $1 billion annually. Meanwhile, Washington Health Benefit Exchange spokeswoman Shawna Crume-Bruce told the media outlet she thinks the $1 billion estimate too high. She says the state Legislature appropriated $5 million per year in state funding for new waiver-eligible groups, but a budget allocation doesn’t mean that’s what this will cost.

In any case, insuring illegal immigrants would be new and is another step toward government-run and -managed health care. Wider paths to government dependency were predictable when the ACA became law.  A letter submitted along with the application and in support of the waiver says it is “one of the most promising opportunities to expand health coverage for Washington residents since the passage of the Affordable Care Act.”

The Biden Administration will almost certainly approve the waiver, making Washington the first state in the nation to provide ACA tax subsidies, regardless of immigration status.

Hovde is the Policy Analyst and Director of the Centers for Health Care and worker Rights with the Washington Policy Center.