Appropriations Committee hears $26 billion overview of Apple Health, exchange and caseload trends

Megan Morris, staff analyst to the Appropriations Committee, told lawmakers the state’s medical assistance programs — branded as Apple Health in Washington — combine Medicaid, CHIP and other specialized programs and together “total $26,000,000,000 in the current biennial budget after the 24 supplemental.”

Morris said the programs covered about 24% of Washington residents last year, including about 46% of children, roughly half of births and 18% of adults ages 19–65. She told the committee that growth since 2014 stemmed from the ACA expansion and the pandemic public health emergency, and that the subsequent end of automatic continuous coverage is expected to reduce caseloads by an estimated 340,000 people from fiscal 2023 to fiscal 2025.

Why it matters: Medical assistance consumes a large portion of the statewide budget and general fund. Morris said Apple Health accounts for about 19% of the statewide $140.9 billion budget and about $5.8 billion — roughly 8% — of general fund state spending in the current biennium, making funding and caseload estimates central to budget deliberations.

Morris outlined how Apple Health is organized and financed. She…