Elizabeth Hovde of the Washington Policy Center explains why the state doesn’t need to be looking for ways to get more people dependent on the government and its taxpayers

Elizabeth Hovde
Washington Policy Center

Washington state has been granted a waiver to federal law allowing it to offer health insurance and subsidies to noncitizens who unlawfully reside in the United States but who live within Washington state’s borders.

The Dec. 9 announcement from the federal government allows the state to suspend a portion of the Affordable Care Act so it can provide access to health insurance to some 105,000 Washington residents who are currently ineligible because of their immigration status. Gov. Jay Inslee said in a statement, “This waiver is an important step toward providing affordable health insurance coverage for all Washingtonians.”

The impact to taxpayers isn’t yet known, as it depends on multiple factors, including how many undocumented individuals and families will take the state up on its offer and what their incomes are. More than just access to coverage, state taxpayer-financed subsidies will be able to extend to new enrollees who make up to 250% of the federal poverty level. The new state benefit could also begin attracting more undocumented immigrants to the state.

What is known right now is that state lawmakers, anticipating approval of the waiver, appropriated an additional $5 million per year in state funding for possible new, non-citizen enrollees and other low-income residents. If enrollment increases up to 105,000 people, that would allow a subsidy of $47.62 each. The state could be greatly underestimating the price tag. Chris Pope, a senior fellow at the Manhattan Institute, previously told The Center Square that for 2020, the Congressional Budget Office estimated $53 billion in subsidies for 9 million enrollees. That equals just under $6,000 per enrollee. Six thousand is a long way from $47.62.

You can add the extra $5 million to $50 million already set aside for subsidized health coverage for those with incomes at or below 250 percent of the federal poverty level. 

Extending state-based coverage and subsidies to undocumented immigrants is another step toward government-run health care, which is a Washington state goal. Washington state lawmakers created a Universal Health Care Commission to pave the way to government-run, universal health care coverage in the state. The group has often considered and talked about getting more people dependent on the state for health care. 

That’s the wrong goal. When we make more people dependent on taxpayer-financed health care — in this and other ways — it increases costs for others who don’t yet need to depend on taxpayers. It can also weaken the system.

Undocumented people should continue to be able to buy health insurance on the private market, as health care is a need we all have. And Washington lawmakers should be considering tax relief and deregulation to help us all afford health insurance. 

The state needs more people prioritizing their health care and devoting money to it in their budgets. It doesn’t need to be looking for ways to get more people dependent on the government and its taxpayers. 

Elizabeth Hovde is a policy analyst and the director of the Centers for Health Care and Worker Rights at the Washington Policy Center. She is a Clark County resident.

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