(The Center Square) – With the future of the Affordable Care Act, also known as ObamaCare, uncertain as Congress remains deadlocked on extending enhanced premium subsidies set to expire at the end of the year, some 80,000 Washingtonians could lose coverage due to steep premium hikes.
The 43-day federal government shutdown was triggered mainly by a congressional standoff over extending enhanced ACA subsidies. Democrats demanded an extension in funding bills, while some Republicans resisted, citing concerns about fraud and cost, which led to a deadlock that paused essential government functions until a temporary deal was reached, leaving the subsidy issue unresolved.
The Washington Health Benefit Exchange operates Washington Healthplanfinder, the state’s online marketplace where individuals and families can shop, compare and enroll in health and dental insurance plans, including Apple Health (Medicaid).
During Thursday’s meeting of the Washington Health Benefit Exchange Board, officials noted that the current open enrollment period has many people opting out of coverage due to concerns about losing subsidies and rising premiums.
“There are two segments of our customer base that are really hurting,” WHBE Chief Executive Officer Ingrid Ulrey said.
She noted that a huge number of those at risk of losing coverage are those under 100% of the federal poverty level.
“This includes unlawfully present immigrants and citizens who have lost access to ACA credits altogether,” Ulrey explained. “Those folks are seeing really big increases, and we are concerned that many of them will drop. And that’s 10,000 people.”
According to her, higher-end earners covered through the exchange are also at risk.
“Those are the folks that are now above the income cap that has been reinstated,” Ulrey said. “We expect higher rates of disenrollment in those two pockets.”
Ulrey then played a video from a woman named Lisa from King County, who testified on Monday as U.S. Sen. Patty Murray, D-Wash., held a virtual event to press for an extension of ACA subsidies.
Lisa said she is retired and on a fixed income.
“So for 2025, I was enrolled in a plan that I paid $870 a month for, and that included an ACA tax credit of $377,” she said. “I’m fortunately very healthy for a person in your 60s and mostly have preventative and routine care. Obviously, right now that $377 a month tax credit has gone away.”
Lisa said she searched on the exchange for a replacement plan with a less expensive policy.
“What I enrolled in was a plan that costs me $1,353 a month more than what I was paying in 2025,” she said.
She said the plan has higher co-pays for visits and less coverage for prescription benefits.
“So even if I remain healthy and don’t have any additional needs, this cheaper plan is going to cost me $6,000 more a year,” Lisa concluded.
The figure that 80,000 Washingtonians could lose health coverage is an estimate from the WHBE and the State Insurance Commissioner’s Office.
Elizabeth New is the director of the Center for Health Care at the free-market Washington Policy Center think tank. She characterized Thursday’s meeting and other health care meetings this week as having a “the sky is falling” tone.
“It’s misleading to say the state budget is so jeopardized by a potential loss of Medicaid clients,” she emailed The Center Square. “Many of the enrollees who leave might find work, encouraged by work requirements, not just drop insurance, and they might be able to leave poverty. That’s a great thing. If Medicaid clients leave, yes, we lose federal money, but we also don’t have to put in the state’s portion of funding for enrollees.”
New suggested the state should set aside any Medicaid client savings.
“In the case that hospitals do receive more people coming in with uncompensated care needs, at least until we see how the dust settles, we can’t let hospitals be even more overwhelmed or cost-shift onto commercial payers,” she wrote.
