HB 1482
In CommitteeHouse
Health coverage access
Assuring equity in health coverage.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill creates a new state-funded health coverage program for low-income immigrants excluded from federal programs due to immigration status, expands financial assistance for private plans on the state exchange, and mandates outreach and accountability measures to improve equity in health coverage. It also requires the state to seek federal flexibility to further expand coverage.
- Establishes a new Apple Health Expansion Program to provide free, full-scope health coverage to adults (19+) with incomes at or below 138% of the federal poverty level who are ineligible for federal coverage due to immigration status.
- Requires the state to provide coverage with benefits and costs equal to standard Apple Health (Medicaid), except long-term services and supports, and to use the same eligibility and enrollment procedures as standard Apple Health.
- Creates a Community Accountability Committee with at least 5 and up to 9 members (majority being program enrollees or community organization staff), tasked with monitoring managed care performance and advising the state on accountability and equity.
- Mandates a state-funded outreach and education campaign—run by the Washington Health Benefit Exchange—to increase enrollment among immigrants, with direct funding to community-based organizations serving immigrant and refugee communities.
- Requires the state to pursue federal waivers to expand coverage and seek parity in financial assistance for immigrants by January 1, 2028, including transitioning lawfully present immigrants with incomes ≤138% FPL to the new state program.
- Amends the Washington Health Benefit Exchange’s governing board composition and reporting requirements to ensure transparency and stakeholder input.
Who is affected
- Low-income immigrants without work-authorized status — Low-income adults (ages 19+) who are immigrants and ineligible for federal health coverage due to immigration status, but meet income eligibility standards for Medicaid or federal subsidies. They gain access to state-funded health coverage with benefits and cost protections equivalent to Apple Health (Medicaid).
- Lawfully present and undocumented immigrants purchasing private plans on the state exchange — Immigrant families who purchase plans through Cascade Care Savings (state-subsidized plans) may receive enhanced state financial assistance to lower premiums and out-of-pocket costs, bringing them closer to parity with federal subsidy levels.
- Community-based organizations serving immigrant communities — Community-based organizations serving immigrant and refugee populations receive direct funding to conduct outreach, education, and enrollment support for the new health coverage programs.
- State agencies (Health Care Authority and Washington Health Benefit Exchange) — The Washington Health Benefit Exchange and Health Care Authority must implement new programs, hire staff or contractors, and report regularly to the legislature and Office of Financial Management.
Pro/Con Analysis
Stronger case for concerns
Potential Benefits (5)
The bill mandates a Community Accountability Committee with stipends for members, but does not create new local government obligations—local governments are not required to fund or staff the committee, and the state provides administrative support, so this has minimal fiscal impact on localities.
Local GovernmentLean peopleRef: Sec. 2(5)(b)The bill amends the Washington Health Benefit Exchange’s board composition to include more consumer advocates and small business representatives, but does not impose new duties or costs on local governments—this is a governance reform with no direct fiscal or operational impact on municipalities or counties.
Local GovernmentRef: Sec. 4(1)(d)The bill requires the Exchange to maintain immigration status confidentiality as if it were a state agency under RCW 43.17.425, but this aligns with existing practice and does not create new local compliance burdens—local law enforcement and courts are not affected.
Local GovernmentRef: Sec. 4(6)The bill provides board members with liability protection for good-faith decisions, but this applies only to the Exchange board—not local officials—and does not alter local government legal exposure.
Local GovernmentRef: Sec. 4(8)The creation of an advisory committee for the Exchange is a non-binding consultation mechanism and does not require local governments to participate or allocate resources—no measurable fiscal or operational impact on localities.
Local GovernmentRef: Sec. 4(7)(a)
Potential Concerns (5)
The Apple Health Expansion Program provides full-scope coverage to low-income, undocumented immigrants at no cost, significantly improving access to care for a historically excluded population—this is a major expansion of public health coverage that directly benefits people who are otherwise structurally excluded from federal programs and face high uninsurance rates.
HealthcarePeopleRef: Sec. 2(1)(c)Direct funding to community-based organizations (CBOs) serving immigrant and refugee communities for outreach and enrollment support ensures culturally and linguistically appropriate engagement, building trust and improving take-up among hard-to-reach populations—evidence from prior state and national programs shows CBOs achieve higher enrollment and retention than top-down or third-party models.
HealthcarePeopleRef: Sec. 3The Community Accountability Committee, with majority membership from enrollees and CBO staff, provides oversight of managed care performance and equity outcomes—this strengthens accountability and helps prevent disparities in care delivery, which can reduce avoidable ER visits and crisis interventions tied to untreated conditions.
Public SafetyPeopleRef: Sec. 2(5)(c)-(d)Coverage must be equal in scope and cost to standard Apple Health (Medicaid), except long-term services and supports, and uses the same eligibility/enrollment procedures—this eliminates administrative barriers and ensures parity in benefits, reducing out-of-pocket costs and improving continuity of care for low-income immigrants.
HealthcarePeopleRef: Sec. 2(2), Sec. 2(3)The requirement to achieve parity in financial assistance for private plans by 2028—including for lawfully present immigrants currently excluded from federal subsidies—will lower premiums and out-of-pocket costs for a group that otherwise pays more for less comprehensive coverage, improving affordability and plan choice.
HealthcarePeopleRef: Sec. 5(2), Sec. 6(1)(d)
Who Is Most Affected
Undocumented adults with incomes ≤138% FPL gain full-scope, no-cost health coverage—this directly improves access to preventive and acute care, reduces financial toxicity from medical bills, and may improve employment stability and school attendance for household members. However, they face no direct costs from the program.
Lawfully present immigrants earning ≤138% FPL who currently receive no federal subsidies may transition to the state program and gain comparable coverage—this improves affordability and equity. However, if federal pass-through funds are unavailable, the state may need to fully fund the program, increasing state costs.
CBOs serving immigrant/refugee communities receive direct funding for outreach and enrollment support—this strengthens community infrastructure, creates jobs, and improves program effectiveness. However, the funding is program-specific and not guaranteed beyond appropriation cycles.
The state (via HCA and Exchange) must implement new programs, conduct outreach, and report to the legislature—this increases administrative costs but aligns with existing infrastructure. No new local agencies are created, and most costs are one-time setup.
Managed care organizations (MCOs) delivering Apple Health Expansion services must comply with new accountability oversight and data reporting requirements—this increases administrative burden but may improve quality and equity. MCOs may face reduced flexibility in benefit design or contracting.