Washington State Opens Health Insurance Enrollment Amid Uncertainty

Starting Saturday, Washington residents can enroll in or modify their health insurance plans through the state’s online marketplace as open enrollment begins. This year’s enrollment comes during a federal government shutdown, which has left the future of crucial subsidies under the Affordable Care Act uncertain.

The federal tax credits that many rely on are set to expire at the end of the year unless Congress intervenes. Disputes between Democrats and Republicans have stalled progress, with Democrats demanding an extension of the subsidies as a condition for ending the shutdown. The lack of these enhanced tax credits, initially introduced during the COVID-19 pandemic, has contributed to a significant rise in premiums for individual insurance on the Washington Health Benefit Exchange, which are up an average of 21%.

Impact of Potential Subsidy Expiration

According to the state Office of the Insurance Commissioner, if the tax credits were extended, premiums could have increased by 6% to 7% less than the current rate. Last year, the average premium increase was 10.7%. As open enrollment progresses, the way Congress decides to handle the tax credits remains unclear, leaving many residents in a state of concern regarding their healthcare costs.

Ingrid Ulrey, CEO of the Washington Health Benefit Exchange, expressed commitment to swiftly deliver any potential relief to customers if Congress approves an extension. Nearly 300,000 residents in Washington purchase insurance through the exchange, with approximately three-quarters qualifying for federal tax credits, reducing their annual premiums by an average of $1,330. For seniors, these savings increase to over $1,900 annually.

Concerns for Rural Communities

The exchange serves individuals who do not have health insurance through employment or government programs like Medicaid. Reports indicate that enrollees in certain regions, particularly rural areas, could see their premiums double without the tax credits. This information comes from a report by U.S. Senator Maria Cantwell, who highlighted that the hardest-hit communities are located in eastern Washington.

Officials anticipate that if the credits are not extended, around 80,000 people may choose to forgo health insurance altogether. Washington’s uninsured rate has been steadily declining, reaching 4.8% in 2023. State officials are concerned that the expiration of these subsidies could reverse this progress, leading to higher healthcare costs and increased strain on the healthcare system as individuals delay preventive care.

“That means higher costs and strains on our health care system as people put off preventative care,” said Patty Kuderer, Washington’s Insurance Commissioner. “These effects will be felt by people across the state, but will hurt some of our rural communities the hardest.”

Health insurance experts warn that those opting to go without coverage are likely to be healthier, potentially leading to further premium increases for those who remain insured. With a less healthy insurance pool, the risk for insurers grows, which could exacerbate the affordability crisis.

Washington does offer alternative financial assistance options, such as the Cascade Care Savings program, designed for individuals earning up to 250% of the federal poverty line. This initiative, which began in 2023, supports nearly 100,000 residents. To address the potential loss of federal tax credits, the exchange is seeking $130 million in annual state funding for the Cascade Care Savings program, contingent upon legislative approval.

Open enrollment is set to continue until January 15, 2024. To begin coverage by January 1, enrollees must sign up by December 15. Those who apply later will see their coverage commence on February 1. Existing customers will be automatically renewed but can still explore other plan options. They have been able to browse their choices and pricing since last week.