Washington Health Care Authority seeks more funding to expand Medicaid for undocumented adults

The number of  undocumented adults seeking Medicaid through Apple Health Expansion is growing. According to the Washington Health Care Authority, more than 10,000 people are eligible but cannot enroll due to limited space. 

For the state’s 2025-2027 biennium budget, the Washington State Health Care Authority is asking for $102,775 in service dollars to add 4,000 individuals to the Apple Health Expansion program on July 1, 2025, and 10,000 individuals on July 1, 2026.

Rebecca Carrell, the deputy division director of Medicaid programs at HCA, said the group is finding ways to provide Medicaid access for undocumented adults. That program enrolled 11,936 individuals as of July this year. 

“We see and recognize the need. At the end of the day, we want to cover as many Washingtonians as possible to create a healthier state,” said Carrell. 

In June, Washington offered Apple Health to undocumented adults 19 or older. There was high demand for the program, which was filled to capacity within two days with over 10,000 people accepted. 

The application is closed, but people can still apply to be moved off the waitlist. Individuals can still complete an application for the program to be considered if space opens up. Individuals who applied for coverage and were denied due to limited space will receive an eligibility notice from HCA if selected for the program.

Apple Health provides coverage for adults earning up to 138% of the federal poverty line. That works out to an annual income of $20,784 for one person and $43,056 for a family of four. 

Xavier Arinez, the Columbia Valley Community Health Center population health director, said many people in Wenatchee received coverage from this program and are able to receive preventative care. While the program is helpful, he said there is still a need to cover more people. 

“We have a significant number of our patients in Wenatchee who declare themselves as being underinsured or uninsured. This impacts the finances of our region’s healthcare providers,” said Arinez. “Cost is the main obstacle as some medical services are not available if payment is not secured. An average out-of-pocket visit to the emergency room could easily cost $2,000 to $3,000 if there is no insurance coverage.”

Washington state is home to more than 240,000 undocumented immigrants according to the Migration Policy Institute. Carrell said that many people are afraid of their privacy due to potential changes in immigration policies with the new presidential administration. 

“We understand the questions about privacy and want to assure the community that their information is protected,” Carrell said.

HIPAA, the Health Insurance Portability and Accountability Act of 1996, protects the privacy of patient’s health information so people can seek medical care without fear of exposure or discrimination. The law applies to all patients regardless of immigration status. Information is only shared in limited circumstances like public health reporting or specific legal requirements.

 Neil Jay Sehgal, the director of the Master in Health Administration program at the University of Washington School of Public Health, said the expansion program will promote early preventative care and help public health. 

“Undocumented residents contribute to the state economy through taxes, such as payroll and sales taxes, and they often lack access to healthcare services. Expanding coverage not only addresses an ethical obligation, but also reduces uncompensated care costs for providers and fosters a healthier workforce,” said Sehgal. 

Reneé Diaz may be contacted at renee.diaz@wenatcheeworld.com. Collaborative reporting by The Wenatchee World, NWPB and WSU’s Murrow College of Communication Newsroom Fellowship.