Officials: Expiring ACA subsidies to impact health coverage for Walla Walla residents

The expiration of Affordable Care Act subsidies at the end of 2025 could leave many people in Walla Walla County without health insurance, potentially impacting health centers in the region.

“Even if the ability to pay for them (health care needs) at the individual level is gone, there are still needs that exist,” said Amy Osterman, healthy communities division manager at the Walla Walla County Department of Community Health.

In 2025, about 1,300 people in the county depended on the subsidies for health insurance, she said.

The biggest concern with the subsidies ending, Osterman said, is that many people in the county could develop major health conditions because they no longer have coverage to treat them at less acute stages.

“So not just a doctor’s visit or one emergency room visit, but something that requires thousands or tens or hundreds of thousands of dollars’ worth of care,” she said.

The subsidies will expire unless Congress extends them and could create a ripple effect of doctor burn out and exacerbated illnesses, area experts said.

According to the Congressional Budget Office, the subsidies — also called premium tax credits — were established under the Affordable Care Act to lower the out-of-pocket cost of premiums for eligible people. ACA enrollment is now estimated to drop from 22.8 million in 2025 to 18.9 million in 2026.

Osterman said the subsidies serve people who do not qualify for Medicaid because they earn above the eligibility threshold but do not have enough income to afford private insurance.

According to KFF, a health information nonprofit, the subsidies’ expiration would cause ACA enrollees’ health insurance premiums to rise by more than 75% on average. Of the more than 24 million Americans who signed up for insurance through the marketplace this year, 9 in 10 receive a subsidy.

Everett Maroon, executive director of Blue Mountain Heart to Heart, a community health organization, said most of its clients are insured through Medicaid, so he does not anticipate the expiration of subsidies affecting his clients directly.

However, he said people losing health insurance through the subsidies will impact hospitals, health centers and health care providers in the county.

As people become uninsured — “which is going to happen to lots of people” — they will be compelled to use emergency departments as their primary source of care.

“That makes a financial strain on our hospital system,” he said. “I don’t really think our health infrastructure can take much more strain than it has.”

This could potentially lead to doctors becoming burned out and moving to another area or curtailing services, Maroon said.

“If you have uninsured people coming to the emergency department, they must be served, but now you (health care providers) are not getting paid,” he said.

Ultimately, this could have an indirect impact on Maroon’s patients, making it harder for them to get specialist care and timely appointments.

“The more we stack on in the form of health care cuts, the more we put people at risk of homelessness, increased substance use disorder rates, malaise, mood disorders and anxiety,” Maroon said.

These cuts, he said, will be especially devastating for people recovering from substance use who need consistent access to medications to maintain their sobriety and for individuals with cancer, heart disease or other chronic illnesses.

“When you’re doing treatment for opioid use disorder, you’re probably prescribing a medication to help control their cravings,” he said. “They need to have some kind of insurance, or they won’t be able to afford the medication.”

Osterman said emergency care is not only more expensive for patients, but the region’s hospital emergency departments also do not have excess capacity to take on more patients than they are already seeing.

There are serious concerns about capacity and staffing in hospitals across the country, she said.

Osterman said Washington offers some state insurance subsidies and Cascade Care plans that can provide more affordable coverage for those who might lose their health insurance next year. People in need can also access the free clinic at the SonBridge Center for Better Living, she said.

Danielle Garbe Reser, chief executive officer of the nonprofit Blue Mountain Action Council, wrote in an email that many households already are struggling with the cost of living, so steep increases in health insurance costs may mean some households cannot stay insured.

She wrote that her organization can assist low-income residents with access to food, housing and utility assistance and help individuals navigate the health insurance exchange.

“I hear a lot of people talking about how they care about rural health,” Maroon said. “I appreciate that talk, but they have to be able to back it up by making a stand here against ending these subsidies.”

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