Republicans must restore health care tax credits

Published 1:30 am Monday, January 19, 2026

There is no issue I get asked about more than affordability. From housing costs to grocery prices, families across Washington and the country are feeling the strain of rising costs.

But no cost is more out of control than health care, and without action, it is only going to get worse.

Health care already takes up a significant share of family budgets. At the same time, we are seeing federal policy decisions drive costs even higher, pricing people out of coverage and putting care out of reach for far too many.

That is what makes this moment so frustrating: this damage is self-inflicted.

Last year, congressional Republicans passed President Trump’s One Big Beautiful Bill (H.R. 1), setting in motion massive cuts to Medicaid and Medicare and allowing the expiration of Affordable Care Act (ACA) tax credits that so many families need to afford care. The bill also creates new administrative barriers to care, limits state funding options, and makes health insurance more difficult to access.

Washington has worked hard to expand health insurance access, which means the consequences of H.R. 1 land especially hard here. An estimated 300,000 to 400,000 Washingtonians are at risk of losing coverage, and our state stands to lose approximately $40 billion in federal Medicaid funding over the next decade.

The impacts will roll out quickly. People who buy coverage through the ACA exchanges are already feeling the pain of those sky-high premium increases from the loss of the tax credits, pushing monthly costs from a few hundred dollars to $1,000 or more. Medicare cuts began early this year, and Medicaid cuts will start later in 2026. Even the roughly 160 million Americans who receive health care through their employers will see costs rise because of hospital closures, service reductions, and cost shifting – all the worse in rural areas like ours.

I have already heard from constituents who face higher premiums, additional barriers to coverage, and growing fear about how they will afford care for themselves and their families.

These cuts will affect people everywhere, but rural communities will be hit especially hard. Small rural hospitals like the Olympic Medical Center in Port Angeles rely heavily on federal Medicaid funding and slashing support threatens access to essential services, and in some cases, the survival of the hospitals altogether.

That’s why it has been so frustrating to see the response from some Republicans in our state. This summer, a Republican House member dismissed concerns about H.R. 1 as “hysterical rhetoric” in an op-ed featured in this very paper. Others have attempted to shift blame to Democrats, pointing to a 1% state-level Medicaid reduction made to meet our constitutional obligation to balance the state budget. That reduction totals about $135 million over two years. By contrast, our state will lose roughly $4 billion every year because of H.R. 1.

Balancing the state budget required difficult choices, but equating a modest state adjustment with the loss of billions in federal funding is misleading at best — particularly when Senate Republicans proposed the same cut but even larger in their own budget proposal.

Again, in our state we are required to write a balanced budget. With that requirement often comes extraordinarily difficult choices. The Trump White House and Congressional Republicans cut your health care and put rural hospitals in jeopardy in exchange for a tax cut for billionaires.

People in elected positions should be solving problems and making things better for everyday Americans — not making millions suffer so the wealthy few can hoard more money than they could ever spend.

I understand why some Republicans in our state are eager to downplay or distance themselves from the worst impacts of H.R. 1 and their party’s abject failure to deliver on health care. But the most important step right now is clear: congressional Republicans must restore those tax credits to limit the harm they’ve already done. Beyond that, we need immediate federal action to rein in health care costs and protect access to care.

Health care shouldn’t be a partisan issue. An illness doesn’t care who you voted for, how much you earn, or where you live. With medical debt a leading cause of personal bankruptcy, it’s clear our current system isn’t working. The choices being made now will determine whether care becomes more affordable — or continues to slip out of reach for families already stretched thin.