Rising Health Insurance Costs in Oregon
Lynn Rosten is feeling anxious about her family’s health insurance expenses for the upcoming year.
This concern intensified recently when Rosten received a letter from her insurance provider.
Starting January, the monthly premiums for her family of three will jump to over $2,000, marking a staggering 45% increase from the $1,377 they currently pay.
Rosten and her husband, both freelancers, buy private health insurance through the state’s Affordable Care Act marketplace, which also covers their 10-year-old daughter. She mentioned they’re living paycheck to paycheck, relying on enhanced federal subsidies that have helped reduce their premiums by about $500 this year.
Unfortunately, that relief is set to fade.
The enhanced subsidies, which were made available during the pandemic and later extended under President Biden’s Inflation Control Act, will cease at the year’s end. The Republican-controlled Congress has opted not to renew them as part of recent tax and spending discussions. These subsidies are at the heart of a congressional impasse that has resulted in a government shutdown since October 1.
Democrats are tying the reopening of the government to the reinstatement of these expanded subsidies, contending that losing them will make healthcare unaffordable for millions. Republicans, however, want to discuss the subsidies independently from stopgap funding measures.
For Rosten, these subsidies were crucial, especially as living costs continue to climb. Both she and her husband work in creative professions—she’s a freelance photographer, and he directs commercials. She expressed that their finances are already stretched thin by increasing insurance rates, fewer healthcare options, and escalating deductibles and co-pays.
“Rent is our biggest expense, but next year’s health insurance premiums will match that,” she shared during a recent news conference with Oregon Democrats. “This is making healthcare almost out of reach, but it’s something we can’t forgo.”
While most Oregonians obtain health coverage through their employers or the state’s Medicaid program, around 140,000 residents rely on Obamacare plans. Many of these individuals are self-employed, small business owners, or freelancers.
The Affordable Care Act has always offered subsidies based on income, allowing those with lower earnings to pay a smaller portion of their income toward premiums. However, prior to 2021, these subsidies were capped for individuals earning up to 400% of the federal poverty level—roughly $62,400 annually for an individual and $128,000 for a family of four. Those above this income threshold were not eligible for any aid.
Emily Gee, senior vice president at the Center for American Progress, noted that Congress temporarily enhanced these tax credits during the pandemic by lifting income limits, making them more accessible and generous.
“These enhanced subsidies have made health insurance much more attainable, especially for rural residents and seniors not yet eligible for Medicare,” she explained. “If we lose them, those groups will be affected the most.”
When the enhanced credits expire, the system will revert to its pre-pandemic structure. Consequently, subsidies for most Obamacare enrollees will decrease, and about 35,000 Oregonians earning over the federal income limit will receive no assistance.
State regulators recently approved next year’s rates, showing that individual plans in the Affordable Care Act marketplace will rise by an average of 10%. Oregonians purchasing private insurance through the Marketplace could see an increase of $127 to $456 a month, depending on their income.
Oregon House Democrats warned at a recent press conference that those with Obamacare could soon face a tough choice: pay higher premiums or forgo coverage altogether.
U.S. Rep. Suzanne Bonamici shared that a 60-year-old constituent managing a small family farm in Clatsop County might see her premiums swell from $230 a month to $1,077 next year.
“It’s unconscionable and unacceptable,” Bonamici remarked. “Thousands of Oregonians find themselves in this same predicament, having to choose between maintaining their insurance and managing their bills.”
Others will endure smaller yet still significant increases.
Gail Manasco, 40, from Bend, shared that enhanced subsidies had saved her $74 a month for her individual plan covering her family. However, she noted that their premiums would rise from $1,700 to over $2,000 monthly.
Manasco added that while families might cope with higher premiums, they also face a shift from preferred provider organizations (PPOs) to exclusive provider organizations (EPOs), which limit coverage to in-network services. If her family’s specialist isn’t included, they may need to switch providers or cover full treatment costs themselves.
“Finding a plan that allows visits to out-of-network doctors is becoming increasingly challenging. Access is significantly limited,” she said. “And yet, our costs keep climbing each year.”
In the meantime, general enrollment for the state’s Affordable Care Act Marketplace kicks off on November 1. Those wishing to shop for a plan must make their selections by December 15.
