Community Health & Wellness
Fewer in Pierce County purchased insurance through the marketplace this year
More than 3,000 fewer Pierce County residents bought health insurance through the state’s Affordable Care Act marketplace this year than last year, a sign that price hikes likely discouraged many from keeping their coverage.
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About 23,950 Pierce residents are enrolled in plans through the Washington Healthplanfinder, the state’s ACA marketplace, according to a recent snapshot report. That is down over 11% from this point last year.
The decline mirrors a trend across Washington. About 250,000 people bought plans through the marketplace during open enrollment. That is down 36,000 people — or about 13% — from the prior year. The Washington Health Benefit Exchange, the agency which oversees the market, said the drop was the largest in the program’s 14-year-history.
The state created its marketplace not long after Congress approved the Affordable Care Act, a federal law commonly called Obamacare, in 2010.
The marketplace allows residents to buy commercial health insurance plans directly from private companies. The market caters particularly to small business employees, independent contractors, and gig workers who cannot get insurance through their work or a government-based program, like Medicaid.
Fears about declining participation in the marketplace started circulating last fall, after it became clear a Republican-controlled Congress was unlikely to extend a pandemic-era subsidy called the enhanced premium tax credit.
Last year these tax credits — adopted in 2021 and later extended through the end of 2025 — benefited a majority of Washington residents who bought insurance on the marketplace. They lowered premiums for thousands and contributed to record enrollment.
Without them, many saw costs surge. Individuals earning about four times the federal poverty level (about $62,000 for an individual) saw their annual premiums increase by over 80% on average this year, Gig Harbor Now previously reported. At its worst, some families reported premiums double or triple in price. A therapist in Bremerton, who spoke to Gig Harbor Now in January, said the premium for her family had risen by over 200%.
The situation left many customers in a predicament: pay the higher premiums or go without insurance. Others may have switched to insurance through their work or changed jobs to remain covered.
State officials originally projected about 80,000 people, close to a third of the marketplace’s shoppers, would drop insurance due to the premium increase. Staff at the Washington Health Benefit Exchange said local efforts, including creating its own premium savings plan, helped cut that original projection in half.
Tara Lee, chief of communications for the exchange, said even though that has kept more people insured, they anticipate that the number of residents choosing to go without health coverage will continue to grow due to ongoing federal changes.
“We are glad that mitigation efforts and the state-funded subsidy, Cascade Care Savings, are helping,” Lee wrote in an email. “It is not nearly enough to backfill the hole left by Congressional action.”
Since the adoption of the Affordable Care Act in 2010, the number of Washingtonians without insurance has declined considerably. In 2010, 14.2% of residents did not have coverage, according to state data. That was down to 4.8% as of 2023.
The end of the enhanced premium tax credit in addition to work requirements for the Medicaid health insurance program slated to take effect nationwide next year, has many worried that progress will start to erode.
“We anticipate the number of people choosing to go without health insurance will continue to increase,” Lee said.