Insurance rates on WA health care exchange set to surge

Top U.S. House Democrat Hakeem Jeffries traveled here Friday to decry rising health insurance costs he says are driven by recent actions from congressional Republicans and the Trump administration.

Low-income Americans face the combination of steep cuts to Medicaid in the years to come and the looming expiration of federal tax credits that help them afford insurance coverage.

Premiums for individual insurance bought on the Washington Health Benefit Exchange through the Affordable Care Act are set to rise an average of 21% next year, state Insurance Commissioner Patty Kuderer announced this week.

This hike is in line with similar jumps across the country. Last year's average rate increase was 10.7%. The state has to approve the rate increases if they're actuarially justified.

Jeffries said he's willing to risk a government shutdown if Republicans don't reverse what he sees as an assault on health care. Congress faces a Sept. 30 deadline to fund the government.

"Democrats will support a bipartisan spending agreement that is negotiated between the House and the Senate, if it lifts up the quality of life of the American people, with a focus on three areas, their health, their safety and their economic wellbeing," said Jeffries, a New York congressman. "We will not support a partisan Republican spending bill that continues to gut the health care of the American people."

Senate Democratic Leader Chuck Schumer said Thursday he and Jeffries are united in opposing any funding plan that doesn't include their health care demands.

Jeffries appeared at a press conference at Overlake Medical Center, alongside Gov. Bob Ferguson, Kuderer and U.S. Reps. Suzan DelBene and Kim Schrier.

"It's great to be with folks who are smart and strategic and substantive and be able to say I'm in Washington at the same period of time," Jeffries quipped.

He was set to participate in a Seattle-area fundraiser Friday evening for DelBene hosted by state Public Lands Commissioner Dave Upthegrove. DelBene chairs the Democratic Congressional Campaign Committee.

Subsidies set to expire

Nearly 300,000 residents buy health plans through the exchange, which serves people who don't get coverage from their work or don't qualify for public programs like Medicaid, known in Washington as Apple Health, or Medicare. Three-quarters of those Washingtonians qualified for federal premium tax credits that helped drop annual premiums an average of $1,330. For seniors, those savings jump to more than $1,900 annually, according to Ferguson's office.

But those subsidies, which began during the COVID-19 pandemic, will expire at the end of the year without congressional action. In July, the exchange reported the expiration would lead to 80,000 people in Washington choosing to forego coverage.

Those who choose to go without insurance are more likely to be healthy, likely fueling further premium hikes for those who remain insured, as the insurance pool would be less healthy overall and more risky for insurers. Nationwide, costs for insurance on the marketplace are estimated to rise more than 75%, with more than 4 million people going uninsured, according to the nonpartisan health research group KFF.

Some Republicans have expressed an openness to extending the tax credits, even if just for one year.

The uninsured rate in Washington was 4.8% as of 2023. For years, the state made progress getting more people health insurance, but officials say that headway is now threatened.

"We've come far in making healthcare more accessible and affordable, but we still have much more work to do," said DelBene, D-Medina. "We should be talking about what we do to go forward, not going backward."

Overlake CEO and President Jon Duarte anticipates hospitals will have to deal with providing more uncompensated care, straining their finances, if the subsidies are allowed to expire.

Kuderer said Congress needs to act quickly if lawmakers are going to extend tax credits, as her office would need to approve revised rates in time for open enrollment, which begins Nov. 1 and lasts until Jan. 15.

The Washington Health Benefit Exchange Board plans to ask the state Legislature for tens of millions of dollars in funding to mitigate the loss of the tax credits.

Meanwhile, the state is also bracing for drastic cuts to Medicaid that Congress passed in the so-called "big, beautiful bill."

The stated goal is rooting out waste, fraud and abuse in the insurance program for low-income Americans.

Critics here in Washington say new work requirements to qualify for Medicaid and other changes in the law could cost the state billions per year in federal funding, force hundreds of thousands of Washingtonians to lose coverage and strain hospitals.

The work requirements don't take effect until January 2027, so it will take a while to know the effects of the law, a cornerstone of President Donald Trump's domestic policy agenda.

Washington State Standard is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Washington State Standard maintains editorial independence. Contact Editor Bill Lucia for questions: [email protected].