Sticker shock: WA health insurance buyers confront steep price hikes

The roughly 300,000 Washingtonians who buy health insurance through the state's online marketplace are set for a rude awakening as they begin shopping for plans.

That's because 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. The steep hikes stem from the expiration of federal tax credits that congressional Republicans refuse to extend.

Similar price jumps are happening nationwide. Last year's average rate increase in Washington was 10.7%. Nationally, over 24 million people are covered with insurance from the marketplaces, which are used by people who do not have access to health insurance through their jobs or from government programs, like Medicaid.

Open enrollment begins Nov. 1, and will run through Jan. 15. To begin coverage by Jan. 1, enrollees should sign up by Dec. 15. Existing customers will be automatically renewed, but can still shop around and compare plans. The window shopping period for plans began Tuesday.

The enhanced tax credits, which began during the COVID pandemic, are central in the federal government shutdown that began Oct. 1.

Democrats in the U.S. Senate have refused to vote to reopen the government without the extension of the subsidies. Republicans haven't yielded to that demand.

Less than two weeks from open enrollment, it's unclear what would happen if Congress decided to extend the tax credits at this late stage.

Insurance companies offering plans on Washington's exchange filed two sets of proposed rate increases with the insurance commissioner, one with the tax credits incorporated and one without. If Congress extends the subsidies, the commissioner would look to approve the alternative rate hikes.

The Washington exchange's CEO, Ingrid Ulrey, said Tuesday that if Congress takes action, "we are committed to delivering that relief to our customers as quickly as possible."

"However, it is complicated and not as easy as flipping a switch," Ulrey added in a statement. "It would be weeks, not days, until the technical changes can be incorporated. But we will make it happen."

Last month, state Insurance Commissioner Patty 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.

"We wish the shutdown would end sooner rather than later," she said Tuesday. "I think the vast majority of Americans out there, especially those who take advantage of the enhanced premium tax credits that allow them to have access to health care, can see the injustice in that, and can see that this is not a functioning government."

Washington officials have said the expiration of the subsidies would lead to 80,000 residents forgoing coverage. The credits save Washington enrollees an average of $1,330 per year, according to Gov. Bob Ferguson's office. For seniors, those savings jump to more than $1,900 annually.

'Significant premium increases'Some Washington counties could see their premiums rise more than others, according to a new report from U.S. Sen. Maria Cantwell, D-Wash.

In Yakima County, where over 5,000 enrollees benefit from the subsidies, premiums are set to go up 133% for those remaining enrolled without the financial help, according to Cantwell's office. Snohomish County could see a 95% hike; Pierce County, 95%; King County, 94%; and Spokane County, 86%.

Cantwell said her constituents who get insurance through the exchange "face an impossible choice."

"Pay hundreds or even thousands of dollars more next year for the exact same plan, downgrade their coverage, or forego health insurance altogether," she said. "Congress must act immediately to extend the expiring Affordable Care Act tax credits or health care will be added to their list of financial burdens."

Sen. Patty Murray said Tuesday that the "Republican leaders' plan is to do nothing while those prices get locked in, and people get priced out of their health care."

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.

The state still offers options for financial help, including Cascade Care Savings for people who make up to 250% of the federal poverty line. The premium assistance program, launched in 2023, helps nearly 100,000 residents.

The exchange is seeking $130 million per year in state funding for Cascade Care Savings to mitigate the loss of the federal tax credits.

"Some of our customers will see significant premium increases due to the scheduled expiration of the federal enhanced premium tax credits at the end of 2025," Ulrey said in a statement. "However, others might be surprised to learn they can retain their same coverage at similar or lower cost."