Not just Medicaid: Hundreds of thousands in WA could lose insurance | Opinion

Congress is considering a federal budget bill that cuts hundreds of billions of dollars from health care programs to help pay for a huge package of tax cuts. And the way they plan to “save money” is by making it much harder for regular, working people to sign up for or keep their health insurance coverage, so there are fewer people they have to pay for.

You’ve probably heard about Congress’s planned cuts to Medicaid (called Apple Health in Washington state). However, another vital source of health care coverage is also at risk: Washington’s state-based marketplace known as the Washington Health Benefit Exchange. This is where people go to buy coverage if they don’t get insurance through a job, like cosmetologists, freelance and gig workers, people in tourism and recreation, early-stage business owners, and others working hard to support themselves and their families. For many, the marketplace/exchange is the only affordable option.

Nearly 300,000 Washingtonians depend on buying health insurance through the state’s marketplace. But the House-passed version of the federal budget — and proposals the Senate is now considering — includes significant new hurdles that would make it harder, slower and more expensive for workers to enroll or stay covered. These changes don’t just threaten coverage, they threaten lives.

Here are some of the most concerning items Congress is considering for the marketplace:

• A shorter timeframe to enroll or switch health plans: Congress would give people a month less each year to sign up or change plans. That may not sound like a lot, but for families and individuals navigating multiple jobs, language barriers, caregiving responsibilities and more, it adds pressure and confusion to an already complex and time-sensitive process. The result? People may not be able to sign up, or they may give up in frustration.
  
  
  
  
• New layers of red tape for tax credits: Many people receive tax credits that help pay their monthly insurance payments, called premiums. If Congress passes this budget bill as written, it would be much harder to get that. Instead of using information states already have, like tax filings, it would force people to go through an entirely separate process to “pre-verify” income, family size and immigration status, three to six months before their coverage would even start or renew. For many, that simply isn’t possible. And, people would have to pay full price until their paperwork is processed. Anyone who can’t afford the first month’s bill at full price is locked out of coverage on the marketplace for the rest of the year.
  
  
  
  Of the 300,000 people in Washington state who rely on Washington state’s marketplace for health care, about 215,000 receive federal premium tax credits. Combining federal tax credits for premium payments with subsidies the State of Washington provides for people under certain income levels, allows them to actually have insurance. At Community Health Plan of Washington (CHPW), 93% of our members receive federal and state assistance to make health coverage accessible.
  
  
  
  
• Penalties for earning too little: Currently, guardrails protect low-income families who miscalculate their income. This budget bill eliminates those protections. Under the House version of the budget bill, someone who misestimates their income and ends up earning $1 less than 100% of the federal poverty level would have to pay back the full cost of their health insurance — but had they made $1 more, they’d pay nothing. Although much is still changing, the current bill takes an aggressive approach that puts families at unnecessary risk.

Health insurance is already complicated. Why are we making it harder, not easier, for people to get the care they need? If a state knows someone is eligible for tax credits, why make them fill out paperwork to tell states what they already know? Why force new parents with low incomes to wait for their child’s Social Security card to arrive to cover their child, or pay hundreds of dollars up front for the coverage that newborns especially need?

Part of the problem is that lawmakers are relying on the difficulty of the new rules for marketplace coverage to make people give up. In fact, the Congressional Budget Office estimates that 3.1 million people nationwide would lose their marketplace health coverage if this budget is passed. Without renewed funding for enhanced premium tax credits, that number could rise to more than 7 million.

These changes don’t just target a program, they target people. At CHPW, we see every day how access to coverage translates into better health outcomes and stronger communities. We also see how easily that access can be disrupted by complex systems that are difficult to navigate.

We urge our senators and representatives to consider the real-life impact of these proposed changes and vote on the side of Washingtonians, trying to build better, healthier lives for their families.

This story was originally published July 3, 2025 at 3:00 AM with the headline "Not just Medicaid: Hundreds of thousands in WA could lose insurance | Opinion."