Nearly 140,000 Oregonians bought health insurance policies for 2025 through the state’s online marketplace. But officials are bracing for those numbers to dip unless Congress steps in to extend enhanced federal subsidies used to reduce consumers’ monthly premiums.
The issue concerns beefed-up premium reduction subsidies launched in 2021 to address the pandemic and help consumers who buy their own health insurance policies but are not on Medicare.
The elevated level of subsidies, coming on top of premium subsidies established previously by Congress, is slated to expire at the end of the year. Many in the health care industry, health care advocates, some conservative activists and at least one U.S. Senator echo state officials’ concern that if Congress does not extend them, people will drop their coverage because of higher premiums.
In Oregon, the average premium paid by consumers enrolled through the marketplace would jump from a little less than $2,000 per year to $3,300 if the enhanced subsidies go away, according to the group KFF, formally known as the Kaiser Family Foundation.
The premium subsidies “make it possible for more working families, small business owners and self-employed people to afford quality coverage through the individual market,” said a statement released by a Regence BlueCross BlueShield spokesperson, Monica Graham. “We encourage Congress to preserve this support so hardworking Americans can continue to choose coverage that works best for their families.”
Oregon Health Authority employees who staff the marketplace website are “working on assessing the potential impacts” of the enhanced subsidies going away, according to a statement released by the Oregon Health Insurance Marketplace spokesperson, Amy Coven. With reduced subsidies, people using the marketplace website will pay higher premiums, the statement added, and “our initial estimates indicate that this may impact older enrollees and rural enrollees more.”
Charles Gaba, a health care coverage activist and analyst, has used his long-running, well-respected blog to provide examples of how Oregonians would be affected. A single parent earning $50,000 a year would see their premium climb from $158 per month to $299 per month, nearly doubling the cost.
A family of four earning $70,000 a year would see their premiums climb by an even higher proportion, from $175 per month to $378 per month, he added.
Meanwhile, Gaba wrote, a 64-year-old couple earning $90,000 a year would have to “shell out” nearly $22,000 more per year to have the same coverage, nearly quadrupling their cost.
‘Bridge’ program for working poor could complicate premium costs
While officials in many Democratic-leaning states are looking for ways to address the likely subsidy reductions, in Oregon that effort may be complicated by a program here that provides free care for a greater number of the working poor, called the “Bridge” plan. It's intended to address health inequities and increase coverage.
In 2024 the state launched the program, which extended the type of coverage offered by the Oregon Health Plan to people who earned a little more. It did so all the way up to 200% of poverty level — which was $29,160 for one person or $60,000 annually for a family of four.
The Oregon program relied on a special federal waiver and followed the lead of only two other states, Minnesota and New York. The new, increased marketplace subsidies launched in 2021 were thought to increase the financial viability of those programs.
In that's true, eliminating the subsidies could hurt the Oregon Bridge plan’s ability to provide care without the state covering a larger portion of the costs. Oregon Health Authority staff were not able to immediately respond to questions from The Lund Report on how the subsidies’ expiration would affect the Bridge plan.
But it's even more complicated than that.
Due to how the Bridge plan interacts with an odd glitch in how the feeral subsidies work, premiums are expected to increase for thousands of Oregonians who make more than the Bridge income cutoff, starting in 2026 and 2027, regardless of what happens in Washington, D.C. And if the federal subsidies are cut, premiums for some Oregonians are projected to climb even higher than national estimates indicate.
Projections relied on by the Oregon Legislature and the appointed Oregon Health Policy Board did not take into account the additional premium hikes that would occur if the federal subsidies expire, instead assuming they would continue.
Subsidies were to help self-employed businesspeople, contractors
Launched around the country in 2013 under the Patient Protection and Affordable Care Act, often called Obamacare, the marketplace websites were intended to make it easier for people who didn’t have job-based or government health coverage to find the best deal and connect with a sliding scale of subsidies based on income.
It was an effort to help people who faced extra challenges finding policies, such as self-employed businesspeople, restaurant staff and contractors.
Now many of those people who received extra help in 2021 may lose it. The effects may not be what Republicans were thinking, however. Among those affected would be people who are financially well off, and 34,000 people in Oregon who make more than quadruple the federal poverty level would pay more if they want to keep their coverage.
According to the statement released by Coven on behalf of marketplace staff, health authority staff “are closely monitoring” the situation.
