Washington state requested a federal waiver May 13 that would allow noncitizens to purchase health coverage on its ACA marketplace, which one expert says may cost the state up to $1 billion every year, according to The Center Square Washington.
If approved, the waiver would expand benefits in 2024 to more than 105,000 people, who could also apply for Cascade Care Savings, the state's new premium assistance program for 2023.
The cost "depends on their income levels, and also on whether the [American Rescue Plan] Act's increase in subsidies is renewed," Chris Pope, a senior fellow at conservative think tank the Manhattan Institute, told The Center Square in an email.
"For 2020, [Congressional Budget Office] estimated $53 billion in subsidies for 9 million enrollees — so just under $6,000 per enrollee," Mr. Pope said.
Under that average subsidy per capita, 105,000 new enrollees would cost just under $630 million annually.
The "per capita amount would probably be higher" in Washington state, according to Mr. Pope. He estimates a total cost of "around $1 billion" annually.
A spokesperson for the Washington Health Benefit Exchange told The Center Square that state residents "newly eligible under the waiver, if approved, will not be getting federal subsidies and tax credits; hence ARPA renewal is irrelevant."
The spokesperson also disputed the $1 billion estimate and said the Washington Legislature has appropriated $5 million annually for noncitizens and other low-income residents.
HHS and the Treasury Department have 45 days to review the waiver, followed by a 30 day public comment period, though the state has requested approval by Aug. 1. Mr. Pope believes the waiver will be found legal as long as the state is the primary funding source.