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Customer testimony underscores premium shock as Exchange braces for end of enhanced tax credits
Summary
At the Dec. 11 Washington Health Benefits Exchange board meeting, CEO Ingrid Ulrey and a customer described early open-enrollment signals amid likely expiration of enhanced premium tax credits: higher premiums, fewer new customers and elevated cancellations — with vulnerable households facing large out-of-pocket shocks.
A retired King County resident told the Washington Health Benefits Exchange board on Dec. 11 that federal changes this year have dramatically increased her health insurance costs and disrupted her retirement plans.
"For 2025, I was enrolled in a plan that I paid $870 a month for, and that included an ACA tax credit of $377," said Lisa Rivland, a customer who described shopping for 2026 coverage on Washington Health Plan Finder. After the federal tax credit was gone, Rivland said, the same plan would have cost her about $1,600 a month — and the plan she selected instead costs $1,353 a month. "So that's $480 more a month than what I was paying in 2025," she said.
Ingrid Ulrey, the Exchange CEO, told the board the agency has set its market assumptions for open enrollment under current law, expecting that congressional votes that day would not extend the enhanced premium tax credits. Ulrey highlighted early signs from the Exchange's channels: a notable spike in Health Plan Finder traffic (initially about a 47% increase in visits), fewer new customers compared with prior years and a higher active cancellation rate.
Ulrey said the Exchange is watching two particularly vulnerable customer groups: lawfully present noncitizen residents who may lose eligibility for tax credits and very low-income households (under 100% of the federal poverty level) who face sticker shock. She said these pockets could yield substantial disenrollment if mitigating policies are not secured. "We think people are waiting, watching," Ulrey said of consumer behavior during the vote uncertainty.
Board members asked staff about the timing for enrollment reporting and the Exchange's approach to mitigation. Ulrey noted the Exchange will not issue a full enrollment report until the end of the first quarter because of auto-enrollment, grace periods and carrier processes. Jim Crawford, the Exchange CFO, told the board the organization is modeling enrollment declines and revenue impacts under conservative assumptions, including expiration of enhanced tax credits and continuation of the current carrier assessment.
Rivland used the board's public-comment time to describe personal consequences beyond finances: she canceled holiday travel and said she may return to work to cover care costs. "I feel like Congress is so easily turning its back on working and retired families," she said. Her testimony was offered as a direct example of the consumer impacts the Exchange staff described.
The board and staff framed next steps as monitoring and state-level mitigation planning: the Exchange is pursuing state funding for Cascade Care premium assistance, exploring benefit and plan-design strategies, and coordinating with the governor's office and partner agencies to limit customer harm if federal subsidies lapse.
The board's record shows the Exchange will continue to model a range of enrollment outcomes and press lawmakers to address affordability for impacted households. The Exchange also reiterated that a fuller picture of whether customers actually disenroll will not be visible until into 2026's first quarter.
