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After a decade of waiting for all residents to have access to Healthcare, Washington State will have it for 2024.


Matt's first questions a decade ago was would healthcare be available for ITINs? The Individual Taxpayer Identification number is how immigrants without a Social Security Number file taxes. The first couple of years that we enrolled people, we literally saw stacks of 1040 tax filings for folks wanting to get Healthcare. 

We had people that when they applied for healthcare discovered that they were not as their parents told them born in the United States. This includes the Dreamers who have been on hold since 2012. Sometimes we got lucky with refugees being granted special status. However for the most part immigrants were blocked from the marketplace. 

We can finally say that 2024, we will have Healthcare regardless of immigration status!

New first-in-kind federal waiver aims to improve access for uninsured Washingtonians

Starting in 2024, all Washingtonians, regardless of immigration status, can get health and dental coverage through Washington Healthplanfinder, and access Cascade Care Savings



OLYMPIA, Wash. – Today, the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Treasury announced approval of Washington’s first-in-kind State Innovation Waiver under Section 1332 of the Affordable Care Act (referred to as a “section 1332 waiver”). This section 1332 waiver authorizes Washington Health Benefit Exchange (Exchange) to expand access to health and dental plans through Washington Healthplanfinder, beginning in 2024.


More than 105,000 Washington state residents — nearly a quarter of the state’s total uninsured population — cannot access health insurance through Washington Healthplanfinder due to federal restrictions related to their immigration status. Starting in 2024, all uninsured state residents – regardless of immigration status — will be able to access qualified health plans (QHPs) and stand-alone qualified dental plans (QDPs), and benefit from Cascade Care Savings (state subsidies that lower premium costs for customers up to 250% of the Federal Poverty Level (FPL)).


“Health care should be accessible, affordable and delivered equitably to all. We are pleased to approve Washington’s Section 1332 waiver to expanded coverage and access to qualified health plans,” Centers for Medicare & Medicaid Services Administrator Chiquita Brooks-LaSure said. “We continue to support state innovation in the ACA Marketplaces that allow residents to enroll in affordable health plan that best fits the needs of themselves and their families.”


This section 1332 waiver, which allows all family members to purchase coverage together through the same plan shopping and enrollment process, will reduce the need for individuals and families in Washington to rely on less affordable or less comprehensive forms of coverage, or on costly emergency room services and uncompensated care.


“We appreciate the federal government’s recognition of our effort to expand our successful state-based marketplace,” Gov. Jay Inslee said. “This waiver is an important step toward providing affordable health insurance coverage for all Washingtonians. Access to health care not only helps strengthen families, it also improves our overall health care system and our state economy.”


Washington’s waiver, submitted in May at the direction of the Washington Legislature, is overwhelmingly supported across multiple sectors. Hundreds of supportive public comments were received at the state and federal level by organizations representing local and national health insurance carriers; provider associations; community health clinics; consumer and immigrant advocacy organizations; elected officials; and Washington residents.


“We are thankful to our Board, the Governor’s office, Legislature, and all of the federal, state and community partners who have worked over the past year to provide access to health and dental coverage for all Washingtonians,” interim Washington Health Benefit Exchange CEO Jim Crawford said. “We now turn to the important work of building the necessary system changes to accommodate new customers and engaging with our community-based partners to inform upcoming implementation and outreach efforts.”


This waiver approval is effective Jan. 1, 2024, through Dec. 31, 2028.


The approval letter, fact sheet and waiver application are available under “Washington” on the federal Section 1332 Waivers website. Additional waiver related materials are available on the Exchange Section 1332 Waiver Information website.

We have been ready for a long, long time. 40% of our area's uninsured are because of Immigration status. 


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