Thousands in Clark County uncertain about health care costs as government reopens without tax credit extension

The cost of health care for about 17,500 Clark County residents remains uncertain after the U.S. government reopened last week without a deal to extend expiring federal tax credits that offset the cost of premiums on some Affordable Care Act plans.

The legislative package ended the longest federal government shutdown in history. But Democrats and Republicans agreed on the spending bill without reaching a clear solution on the tax credits — the main point of contention for Democrats.

Senate Republicans agreed to hold a separate vote on extending the Affordable Care Act tax credits by mid-December, although House GOP leaders have signaled they may be unwilling to compromise on the issue.

Speaker of the House Mike Johnson, R-La., said there would need to be “massive reforms” on the insurance policy before he would consider an extension of the tax credits.

Open enrollment for the Affordable Care Act Health Insurance Marketplace began Nov. 1 and closes Jan. 15. According to the Washington Health Benefit Exchange — the agency responsible for the operation of Washington’s insurance marketplace — some customers are experiencing sticker shock, while others are still finding plans with affordable prices.

“The amount that health insurance premiums will increase varies widely based on whether or not customers receive federal tax credits (most of our customers do — around 75 percent) and factors such as income, age and where someone lives,” Washington Health Benefit Exchange’s associate director of strategic communications, Ilene Stohl, said in an email.

In 2025, the Affordable Care Act tax credit helped 217,000 Washingtonians afford health insurance coverage for themselves and their families, according to the Washington Health Benefit Exchange.

In Clark County, 17,574 residents, or about 4 percent of the total population, receive the tax credits. A recipient’s net premiums could skyrocket 85 percent if the credits are not renewed, according to the Washington Health Benefit Exchange. Statewide, the organization projected that premiums will increase by 65 percent due to the expected expiration of enhanced premium tax credits, Stohl said.

Sen. Maria Cantwell, D-Wash., who voted against the bill, said that a spike in health insurance costs would impact the economy at large, as well as everyday people and small businesses.

“This bill doesn’t address the core issue that millions of Americans will no longer be able to afford ACA insurance coverage next year,” Cantwell said in a Nov. 9 news release. “I’m willing to work with anyone to create a path forward, but this isn’t it.”