Walla Walla residents drop health insurance because of affordability under Trump

Hundreds of Walla Walla County residents can no longer afford health insurance after the expiration of the enhanced Affordable Care Act subsidies under the Trump administration.

The change is likely to create a ripple effect, resulting in economic losses and increased medical debt.

"Working-class people and middle-class people are being squeezed out," said Tara Lee, the chief communications officer at the Washington Health Benefit Exchange, which helps Washingtonians access health and dental coverage.

At least 725 people have dropped their health insurance over the past year, according to data shared by the Exchange.

Lee said people may drop coverage for several reasons, such as obtaining employer-sponsored insurance through a spouse. However, she said the expiration of the enhanced subsidies is the biggest factor driving the decline because it has made health insurance significantly more expensive.

"We have never seen a drop like that in the history of the Exchange, which dates back to 2013," she said. "Affordability is the number one reason that people drop health insurance."

The subsidies, also called premium tax credits, were established under the Affordable Care Act to lower out-of-pocket premium costs for eligible individuals.

The enhanced premium tax credits expanded eligibility for the federal subsidies, allowing more people to qualify. President Donald Trump's tax and spending bill did not extend the enhanced tax credits, and they expired at the end of 2025.

The federal government shut down for 43 days, from Oct. 1 to Nov. 12, after Democrats demanded an extension of the enhanced tax credits and Republicans refused.

Since the expiration, fewer people are eligible for federal subsidies, and those who remain eligible receive less financial assistance.

In a previous interview, then-Washington Health Benefit Exchange Chief Executive Officer Ingrid Ulrey said individuals who are no longer eligible have seen health insurance premiums increase by as much as 2,000% this year.

The people most affected are those nearing retirement age who do not yet qualify for Medicare, small-business owners, ranchers, farmers and individuals who earn too much to qualify for Medicaid but do not have access to employer-sponsored insurance, she said.

Washington also provides subsidies through its Cascade Care Savings program to help eligible residents lower their health insurance premiums. However, Lee said the program has a limited budget that is not enough to help every resident who lost the enhanced tax credits.

"The money from the state does help, but it certainly is not a replacement for the federal subsidies," she said.

As health insurance becomes less affordable, she said, medical debt will increase.

A 2024 Washington state health care affordability survey found that high health care costs lead many Washingtonians to delay medical treatment and incur debt. Of the more than 1,000 residents surveyed, 31% live in a household with medical debt. Additionally, 57% of respondents reported avoiding medical treatment or modifying their use of prescription medications because of the cost.

Lee said she has heard from many residents who have had to cut out other expenses to afford health insurance, especially amid rising gas and grocery prices. That creates a ripple effect throughout the local economy.

"People aren't spending money at local businesses," she said. "They have less money for shopping in stores or eating at restaurants."

In a previous interview, Everett Maroon, executive director of community health organization Blue Mountain Heart to Heart, said that as more people lose health insurance, they will increasingly rely on emergency departments as their primary source of care. Under federal law, hospitals must provide emergency care regardless of a patient's ability to pay, but providers often are not fully compensated for that care.

That could lead to physicians becoming burned out, relocating to other communities or reducing services, he said.

"I don't really think our health infrastructure can take much more strain than it has," he said.

Amy Osterman, healthy communities division manager at the County Department of Community Health said the only other option for many people who no longer qualify for federal subsidies is to pay the full cost of health insurance themselves.

"We have not identified other resources for those individuals," she said.

Osterman encourages those in need to contact Greater Health Now, a health insurance navigator, to determine whether they qualify for other benefits.

"It's becoming more challenging for county residents to find affordable health care coverage," she said.

© 2026 Walla Walla Union-Bulletin (Walla Walla, Wash.). Visit union-bulletin.com. Distributed by Tribune Content Agency, LLC.