Despite passing the largest tax increase in Washington state history and record revenues, lawmakers now find themselves staring down a massive budget shortfall, and one of the programs at the center of the controversy is a $150 million, state-funded Medicaid-style healthcare expansion exclusively for illegal immigrants.
In an interview on The Ari Hoffman Show on Talk Radio 570 KVI, Center Square investigative journalist TJ Martinell detailed how Washington’s Apple Health Expansion program, a taxpayer-funded healthcare initiative, was quietly rolled out for undocumented immigrants, with little vetting and almost no public attention.
Washington State Faces Budget Crisis Amid $150M Medicaid Program for Illegal Immigrants
“It’s like watching a train headed for a broken bridge. You can see the crash coming, but no one’s hitting the brakes.” @TJMartinell1 pic.twitter.com/ZEm1hgdBeU
— Ari Hoffman 🎗 (@thehoffather) July 17, 2025
“This is a state-funded Medicaid-style program,” Martinell said. “The federal government doesn’t fund it. It’s entirely on Washington taxpayers.”
No Proof of Legal Status Required
According to Martinell, applicants to the program are not required to provide proof of immigration status, a key feature, given that the program is intended only for illegal immigrants.
“They are not required to provide any documentation of their immigration status,” he said. “It’s for people who are here illegally and who can’t prove they’re not.”
The program, launched on June 20, 2024, quickly hit its cap of 13,000 enrollees within 48 hours. Another 17,000 people remain on a waiting list, and efforts to expand access this session, including House Bill 1482 from Rep. My-Linh Thai (D-Bellevue), failed to gain traction in committee.
While the bill didn’t receive a public hearing, it would have extended benefits to all immigrants regardless of legal status and funded outreach campaigns to help enroll even more. Though shelved for now, policy analysts warn that the push to grow the program will return.
Budget Blowout and Underfunded Priorities
The timing couldn’t be worse. Washington state is heading toward a projected $400 million deficit by 2028, and that’s after raising $9 billion in new taxes. Earlier this month, the Washington State Economic and Revenue Forecast Council revealed that the state is expected to collect $720 million less than originally forecast over the next four years.
Meanwhile, critical programs that serve legal residents, like traditional Medicaid, are suffering.
“We’re at a point where medical providers are being chronically undercompensated for Medicaid patients,” Martinell said. “Many of them aren’t even accepting new patients because they just can’t afford to.”
Rather than boost reimbursements to struggling providers, lawmakers instead funneled millions into a new entitlement for individuals living in the U.S. illegally.
“You’re spending roughly $11,000 per person over two years,” Martinell noted. “And that’s assuming the program stays capped.”
He also warned of a hidden cost: illegal immigrants not enrolled in the Apple Health Expansion are still using emergency rooms, often without paying, pushing those expenses onto insured, legal residents through higher premiums and hospital fees.
“In effect, Washington residents are paying twice, once through this program, and again through higher healthcare costs,” Martinell said.
Ferguson, Planned Parenthood, and the Bigger Picture
The debate over spending priorities intensified last week after Gov. Bob Ferguson announced that the state would use taxpayer funds to replace federal dollars cut from Planned Parenthood, even as the state faces a looming fiscal crisis.
“You’ve got more money coming in than ever, and they’re still short,” Martinell said. “It’s like watching a train headed for a broken bridge. You can see the crash coming, but no one’s hitting the brakes.”
As the budget gap grows, critics are questioning whether high-cost, ideologically driven programs like Apple Health Expansion are sustainable, especially when the state can’t even adequately fund core services.
So far, Democratic lawmakers have largely defended the program. Rep. Dan Bronoske (D-Lakewood), chair of the House Health Care & Wellness Committee, argued that providing healthcare to illegal immigrants can reduce strain on emergency rooms and prevent costlier health crises down the road.
But Martinell says that just shifts the burden from one group of taxpayers to another.
“Instead of passing the cost onto hospitals or insurers, now they’re just passing it directly to the taxpayer.”
The Road Ahead
The Apple Health Expansion program, created through 2022 and 2023 legislative appropriations, could become a political flashpoint as budget pressures mount. While expansion was shelved this session due to financial constraints, experts say the program is unlikely to stay capped for long.
“This is just the beginning,” warned Elizabeth New, healthcare director for the Washington Policy Center. “I’m sure they’ll try to increase it again.”
Whether lawmakers have the political will to rein in spending or continue expanding entitlements in a time of financial strain remains to be seen. But for now, as Martinell put it, “the train’s still moving, and the bridge is still out.”
