County-Based Coverage for Adult Immigrants

A new report recommends county-based coverage programs as a new approach to provide comprehensive health care to uninsured immigrants across Washington State.

NoHLA recommends county-based health coverage programs as a new approach to providing comprehensive health coverage to uninsured immigrants across Washington State. County-based programs in other states suggest ways for Washington counties to provide more consistent access to health care services, reducing expensive and avoidable emergency care and mitigating long-standing health inequities.

Many low-income Washington residents are not eligible to access health care through public programs such as Medicaid, Medicare, and subsidized health insurance under the Affordable Care Act (ACA), due to their immigration status. While children generally have access to Washington Apple Health regardless of immigration status, adults do not. To address these gaps, many counties across the country have implemented health programs to increase access to health care services for adults. We have highlighted six such programs in this report. Based on our review, we provide recommendations for developing similar programs in Washington State counties.

Based on our research and an economic analysis prepared by HealthTrends, we offer initial recommendations for program components for Washington counties to consider, including eligibility criteria, enrollment process, model for providing care and participating providers, and benefits and out-of-pocket costs.