WA is taking steps to expand health insurance coverage to all residents, regardless of immigration status

Washington has taken a significant step in extending health and dental coverage to nearly all residents, especially those who are undocumented.

The Washington Health Benefit Exchange, the state’s marketplace for health insurance, filed a waiver application Friday that, if approved, would allow states to circumvent or modify some Affordable Care Act requirements. If the federal government gives the green light to the waiver in the coming months, thousands more Washingtonians will be eligible for new health and dental benefits beginning in 2024, the exchange said in a statement this week.

“Since the inception of the Affordable Care Act, we have embarked on a course to provide health care coverage to all Washingtonians,” Gov. Jay Inslee said in the statement. “This waiver comes at an important time in our healthcare journey, and its approval would strengthen our ability to provide equitable access to historically marginalized and uninsured populations.”

If the waiver is approved, the state could become one of the first in the country to offer comprehensive benefits regardless of immigration status.

About 2 million Washingtonians currently receive healthcare through the exchange, said Michael Marchand, the marketplace’s chief marketing officer. Under the ACA, undocumented immigrants (with the exception of pregnant women and children) are not eligible to purchase health insurance through wahealthplanfinder.org, an online tool managed and operated by the exchange.

The waiver would expand access to more than 105,000 people — about 23% of the state’s total uninsured population, according to the application.

“We hear far too many stories of people putting off care because they don’t have insurance until it becomes a huge health and financial burden on them,” Marchand said. “And then they use the ER as their family doctor, which ends up being more expensive for all of us.”

According to a 2020 report by the Kaiser Family Foundation, the federal government has approved exemptions from several other U.S. states, including Oregon, Colorado, Alaska, Montana, Georgia, Pennsylvania and Maine, although none of the requests related to immigration status.

In 2016, California petitioned to expand access to health insurance for undocumented immigrants, but state lawmakers withdrew the request the following year over concerns the Trump administration would use information from the plan to deport residents, Kaiser reported Health News.

Plans to file the waiver have been underway since last year, when state legislation directed the exchange to explore different coverage options for those who don’t qualify for state or federal health insurance. In the past, the Centers for Medicare & Medicaid Services has also encouraged states to take advantage of Section 1332’s “flexibility.”

In Washington’s motion, the state is asking that a certain section of the ACA that prevents undocumented immigrants from purchasing health insurance through the Healthplanfinder be removed.

The application is now in the hands of the U.S. Departments of Health and Human Services and the Department of Treasury, who will evaluate whether the coverage offered under the waiver is “comprehensive, affordable, results in coverage gains, and does not increase coverage for the federal deficit,” the statement said.

The waiver would also leverage state-funded affordability programs that help reduce premium costs for customers, in addition to improved access to Cascade Care Savings, the state’s new premium support program due to open this fall.

“There are many in our state who have never had the opportunity to purchase health insurance,” Pam MacEwan, the exchange’s CEO, said in the statement. “This waiver gives these individuals the opportunity to secure meaningful health insurance for themselves and their loved ones.”

The federal government has up to 45 days to review the application before adhering to a one-month public comment period. It then has up to 180 days to respond to the request, though the state has asked for approval until early August.

“Over time, we’ve received increasing requests to target specific populations to reduce the total number of uninsured in Washington state,” Marchand said.

Though the state has been busy for the past two years ensuring people who lost their jobs during the pandemic don’t slip through coverage gaps, Marchand said it was exciting to submit the waiver application and potentially open doors for a “population.” that, in the past, has been overlooked.”

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