The Departments of Health and Human Services (HHS) and Treasury approved a program Friday that will allow the state of Washington to use federal pass-through dollars to subsidize the healthcare of illegal immigrants.
The state’s Washington Healthplanfinder, created under Section 1332 of the Affordable Care Act, will be subsidized by the federal government from 2024 – 2029, according to a notice of approval submitted to Democratic Gov. Jay Inslee. Section 1332 provides for state innovation waivers, which allow states to “to pursue innovative strategies for providing residents with access to high quality, affordable health insurance.” Washington is the second state to use the provision to fund healthcare for illegal immigrants, joining Colorado.
The Affordable Care Act restricts individuals who are not citizens or “alien[s] lawfully present in the United States” from buying subsidized health insurance through federal exchanges. However, Section 1332 state exchanges do not necessarily restrict such purchases, and are funded with federal pass-through dollars. The subsidies are technically compliant with federal law because the funds are not provided directly to the illegal immigrants.
“The state can then use pass-through funding for purposes of implementing its approved waiver plan. This includes using the pass-through funding to provide state subsidies to those not currently eligible for federal subsidies under the ACA, and to fund other state affordability programs,” a spokesperson for the Center for Medicare and Medicaid Services (CMS) within the HHS previously told the Daily Caller.
Washington argued in its waiver application that covering illegal immigrants would actually drive healthcare costs down, since “individuals without a federally recognized immigration status tend to have lower claims cost than lawfully present residents.”
“Prior research has shown that controlling for factors such as insurance status, spending among undocumented individuals is approximately 25% lower than among those who are lawfully present. Another study found that immigrants without proper documentation spent 50% to 60% less than U.S. born individuals per capita,” the filing ads.
SEATTLE, WA – MARCH 16: Washington state Governor Jay Inslee, joined by King County Executive Dow Constantine and Seattle Mayor Jenny Durkan hold a press conference to provide details on a temporary statewide shutdown of restaurants, bars, and entertainment and recreational facilities to mitigate the effects of the COVID-19 outbreak, on March 16, 2020 in Seattle, Washington. (Photo by Elaine Thompson – Pool/Getty Images)
During a 2020 presidential primary debate, several Democratic candidates declared their support for making government-funded healthcare available to illegal immigrants. Inslee, who did not participate in the debate, did not reveal his position on the issue during his failed campaign.
Washington estimated in its application that 479,800 of its residents do not have health insurance. A spokeswoman for the Washington State Health Care Authority told the Daily Caller that the state estimates 105,000 of those are illegal immigrants. (RELATED: EXCLUSIVE: Republicans Propose Banning States From Funding Health Insurance For Illegal Immigrants)
“At a time when President Biden’s inflation crisis is already increasing the financial burdens on health care providers and families in Eastern Washington and across the nation, health care premiums and costs are rising substantially. Rather than using federal funds to mitigate some of these costs for health care providers and Washingtonians, Governor Inslee would rather spend it on undocumented immigrants,” Republican Washington Rep. Cathy McMorris Rodgers said in a statement.
All three Republican members of Colorado’s congressional delegation introduced legislation in July prohibiting states from using pass-through money to subsidize health insurance for illegal immigrants. Republicans have long expressed concern about the issue, but Democrats denied as recently as 2021 that federal tax dollars could fund health insurance for illegal immigrants.
“Where the law as it stands now as I see it, it does not allow those who are unauthorized in this country to receive taxpayer-paid benefits except in very rare circumstances,” HHS Secretary Xavier Becerra testified at his confirmation hearings. “And it will be my job to make sure that we are following and enforcing the law.”