OLYMPIA — Republican lawmakers are protesting a proposal by Gov. Christine Gregoire and Democratic lawmakers to expand state-funded health coverage for children of illegal immigrants.

"They're not even citizens," said Rep. Bill Hinkle of Cle Elum, the ranking Republican on the House Health Care and Wellness Committee.

Hinkle said it doesn't make sense to cover illegal immigrants when there are so many other shortcomings in the state's health-care system.

"This just drives folks back home nuts," he said.

But the move is drawing widespread praise from hospitals, doctors and children's advocates.

"In our opinion, every child should have medical coverage and be able to get medical care," said Jon Gould, deputy director of the Children's Alliance. "We shouldn't play politics with children."

Cassie Sauer, spokeswoman for the Washington State Hospital Association, said hospitals are required to treat any child who comes in with a medical emergency. If that child happens to be an uninsured immigrant, the costs simply get passed on as a "hidden tax" to other patients who have insurance, she said.

It's far less expensive, Sauer said, to include those kids in health programs that provide basic preventive care, such as immunizations.

"If you intervene early in a child's sickness, you can usually get them back on track pretty easily," Sauer said. "If you wait too long, then you can be dealing with really serious issues."

The federal government doesn't allow states to cover illegal immigrants under Medicaid, a state-federal health program for the poor. Legal immigrants are required to wait five years before they can get coverage.

For more than a decade, the state provided coverage to the poorest immigrant kids through the Children's Health Program. But the program was eliminated five years ago, when the state was wrestling with a budget deficit.

Gregoire and the Legislature reinstated the program in 2005 and last year included funding for 14,000 enrollment slots. But as of last month, only about 8,300 children had been signed up.

State officials say the main reason the program hasn't filled up is that families don't meet the income eligibility requirements.

The program now is open only to children in families that are at or below the federal poverty level, which last year was about $20,000 annually for a family of four.

Gregoire this week proposed increasing the eligibility level to 250 percent of the federal poverty — about $50,000 for a family of four.

"Fundamentally, [Gregoire] believes that kids are kids, irrespective of how their parents came here," Christina Hulet, the governor's chief health-policy adviser, told the House Health Care Committee on Monday.

Republicans said they were caught off guard by the proposal. They pointed out it was not one of the changes recently agreed to by the governor's bipartisan Blue Ribbon Commission on Health Care.

Hinkle and Sen. Linda Evans Parlette, R-Wenatchee, who both served on the panel, said the group was unable to reach a consensus on coverage for immigrant children. They said the governor's proposal would threaten other efforts to reach bipartisan accord on health-care fixes.

"It's like throwing gas on the fire," Hinkle said.

At a time when nursing homes, rural physicians and others are calling for higher Medicaid reimbursement rates, Hinkle said the state can't justify adding coverage for illegal immigrants.

But Sauer said the state should be dealing with all of those issues. The bottom line, Sauer said, is that hospitals already have a "moral and legal" obligation to all kids and don't check to make sure they are legal citizens.

"We're not the border patrol," Sauer said. "We're health-care providers."

Ralph Thomas: 360-943-9882 or rthomas@seattletimes.com