Legislature funds future health coverage for uninsured adults, including immigrants

Immigrants who cannot currently access health insurance in Washington may soon have options.

Lawmakers approved funding earlier this year to pave the way to coverage for hundreds of thousands of Washington residents who do not have health insurance.

There are an estimated 465,000 uninsured Washington residents, and an estimated 105,000 of them also lack federal immigration documents.

A coalition of dozens of community groups and advocacy organizations called for lawmakers to fund health insurance for all immigrants regardless of documentation or legal status in the country.

The 2020 Washington Immigrant Health Access survey, which focused on participants 18 and older who do not qualify for state health insurance, found that two key barriers to accessing health care were lack of health insurance and the high costs of care.

The pandemic made already difficult access to care even more stressful. Since February 2020, 90% of survey respondents had lost their job or reported lower income, and many of them were working in high-risk, in-person jobs during the pandemic.

“What we’ve seen is the pandemic has laid bare the urgency of this problem,” said Sarah Dixit of the Asian Pacific Islander Coalition of Spokane, which is one of the groups advocating for the extended health care coverage.

Lawmakers allocated $12.1 million to three state agencies to begin the process of building coverage programs for these uninsured Washington residents.

Some of the funding will go to the Health Care Authority to build a Medicaid-parity program that would cover uninsured individuals who would qualify for Medicaid if they were eligible, up to and below 138% of the poverty level.

For those who wouldn’t qualify for that program, the state would need to create a way for others to purchase their insurance on the health benefits exchange, which means the state likely will need to apply for a federal waiver from the Center for Medicare and Medicaid Services.

The programs would not be implemented until 2024, and the legislative supplemental budget plan sets aside millions to be invested in them in 2023 ahead of their launch.

“It’s heartening to see there’s a commitment from the Legislature to immigrant communities and this is starting to take shape as a program in their minds,” said Emily Brice, senior attorney at Northwest Health Law Advocates.

Undocumented immigrants, including recipients of Deferred Action for Childhood Arrivals, or DACA, cannot get covered on Medicaid or buy health care coverage on the benefits exchange. Even some immigrants with documentation cannot access one or both of the programs, depending on what kind of visa they have or their immigration status.

The exception in Washington is that pregnant people and children are eligible for Medicaid coverage regardless of immigration status.

Coalition members praised the Legislature for dedicating funding to this coverage, but also note that health insurance is just a first step. Other barriers to care like transportation and translation are also important for communities to access the care they need.

“What is the next step in terms of planting more clinics or working with clinics that exist?” Dixit said.

Lili Navarrete, with Raiz of Planned Parenthood of Greater Washington and Idaho, grew up without health insurance and remembers her mother making home remedies instead of taking sick family members to the doctor .

She said there are still families doing this for fear of not having health insurance or being unable to afford the care they might need.

“That’s why we advocate and fight and take our voices to the Legislature, to have money provided so people can have access to insurance or health care,” Navarrete said.