Community Health & Wellness

Health insurance may get a lot more expensive soon for thousands of Washingtonians

Posted on October 13th, 2025 By: Conor Wilson

Thousands of Washington residents who get insurance through an online marketplace known as the Washington Healthplanfinder are weeks away from the start of open enrollment. How much they’ll pay for health and dental coverage next year– and whether some will be able to afford it – remains an open question.

An enhanced premium tax credit will expire at the end of the year unless Congress renews it. The pandemic-era subsidy introduced in 2021 curbed costs for about three-quarters of the 286,000 Washingtonians who get insurance through the marketplace.

Debates over that subsidy are at the center of the current federal government shutdown. Democrats in Congress want the Republican majority to extend the tax credit before they agree to approve funding to reopen the government. Republicans want to negotiate after resolving the shutdown, leaving state officials concerned about what will happen if the credits expire.

Rising costs for consumers

Premium costs could rise by more than 60% for the average beneficiary buying on the marketplace. Some customers could pay up to twice as much. An estimated 80,000 Washingtonians may no longer be able to afford coverage.

Combined with Republicans’ sweeping reconciliation bill adopted earlier this year – which is estimated to leave up to 200,000 without insurance largely due to changes to Medicaid – Washington’s uninsured population is projected to double. That would put additional financial pressure on the state’s already fragile medical system.

“Failing to extend these common-sense tax credits is one more way the federal government is making health care less affordable and less accessible to residents across our state,” Washington Gov. Bob Ferguson said in a statement. “Congress must act now to extend these credits and protect health care access for tens of thousands of Washingtonians.”

People without insurance often delay seeking care until it is absolutely necessary, forgoing less-expensive preventive care until they wind up in emergency rooms. That can force hospitals — many of which are already struggling and have laid off employees in recent months — to provide more charity care, or services to the uninsured without payment.

Hospitals may raise prices

To compensate, hospitals likely will raise prices and lean more heavily on commercial insurance recipients, said Ingrid Ulrey, CEO of the Washington Health Benefit Exchange.

“The risk is a big increase in folks in our state who are uninsured and that impacts everybody,” she said. “We don’t want to destabilize our health care system.”

In a statement, U.S. Rep Emily Randall, D-Bremerton, said she wrote to House Speaker Mike Johnson, R-Louisiana, demanding he call the House back into session. She blasted his unwillingness to negotiate with Democrats as a “betrayal of his duty to the American people.”

About 19,900 people in Randall’s district — which spans the Olympic and Kitsap Peninsulas, Gig Harbor and part of Tacoma — benefit from the enhanced premium tax credit, according to the Washington Benefit Exchange.

“Every day of inaction is another day that families in Washington’s 6th District and across the country lose sleep worrying about how they’ll afford their medications, doctor visits, and chemo treatments,” Randall said in a statement. “I refuse to give up, and I refuse to look away while Speaker Johnson plays politics with people’s lives.”

Falling through the cracks

Legislators have until the end of 2025 to extend the enhanced premium tax credit. But further delay is likely to add confusion and uncertainty as it bleeds over into the open enrollment window. Starting Nov. 1, individuals can renew or purchase health and dental insurance coverage for the upcoming year on the Washington Healthplanfinder.

Open enrollment is always stressful for staff at the Washington Health Benefit Exchange, who oversee the Washington Healthplanfinder marketplace. This year is particularly unique. When staff start sending out notices in late October, they will assume the enhanced tax credits will not be renewed, Ulrey said. They are ready to pivot if Congress extends the tax credits, she said.

The Washington Healthplanfinder has for years caught people “who were falling through the cracks” and lack access to insurance, Ulrey said.

Most, but not all, Americans fall into one of two camps: Either they get insurance through their job, or from a government program like Medicaid, Medicare or Tricare.

The marketplace

Lawmakers designed the federal Health Care Marketplace as a third option. Created through the Affordable Care Act, a federal law often called Obamacare, the marketplace provided a government-run platform for individuals to browse and purchase private insurance plans. Most states use the federal system. Some, like Washington, have a state marketplace.

People who rely on the marketplace typically include small business owners, the self-employed, contractors and people who retire before they are Medicare-eligible. Rural areas have the highest percentage of people benefiting, Ulrey said.

Opening the marketplace reduced the number of uninsured Americans, allowing them to buy discounted insurance plans for themselves and their families. The Affordable Care Act capped premium prices on the marketplace for many enrollees at a certain percentage of their income. The enhanced premium tax credit, introduced in 2021, lowered those caps further while expanding eligibility for subsidies.

Expanded benefits could be gone by January, costing Washingtonians an estimated $285 million in savings.

Even if the tax credits ultimately come through, Ulrey fears some damage may already be done. Many customers could get “sticker shock” from seeing the price increase and drop out. At that point, she says, it would be difficult to bring them back. Nobody knows if savings would apply retroactively, she said.

“There has been remarkable progress and gains since the passage of the ACA,” Ulrey said. “Much of that is now in jeopardy.”