In a span of 24 hours, President Donald Trump issued two major blows to Obamacare. The latest came in an announcement that he will halt federal subsidies for cost-sharing reductions (CSRs).
By law, insurance companies will still have to pay for the no-longer subsidized CSRs, but to do so they will increase premiums.
The Washington State Health Benefit Exchange planned for this possibility and asked insurers to submit a second set of premiums based on this scenario.
While this means no immediate change to rates for this year, we could see a big increase for next year, in particular for people who buy a "Silver plan" on the health care exchange.
61-year-old Connie Wellnitz, a professional house painter, is grappling with the announcement.
"I realize Obamacare had issues, but it's like throwing the baby out with the bathwater," she said.
The private contractor is one of the 73,000 people in Washington state who get the federal cost-sharing subsidy which helps reduce co-pays and deductibles.
Losing it can drastically increase the monthly insurance bill.
For example, take a 45-year-old woman making $50,000 a year who buys a Silver plan on Washington Healthplanfinder, the state's health insurance marketplace. She currently pays $270 a month in premiums.
First, factor in the already expected average 22 percent increase in premium rates for 2018. Then add on the new cut in federal subsidy could raise rates another 9 to 27 percent.
That means the woman's premium could become anywhere from $359 to $418 a month.
However, those calculations do not account for a person's tax credit, if she receives one, which can also increase and help mitigate higher premiums.
"With the additional increases in those Silver plans, those tax credits go up," said Michael Marchand, spokesperson for the Washington Healtplanfinder. "So for a lot of people, this will be a wash. But it does cause great concern for people who aren't getting subsidies. And that's something we want to be able to look at."
Marchand says the people who will be hit the hardest are those who buy the Silver plan but make too much money to get a tax credit. He believes much could change in the next few days or even weeks before the premiums are finalized.
"Really there's nothing someone could do until there is some sort of finality," said Marchand. "And until November 1 when you can look at what the costs will be. I think it will be a few days to see how things shake out."
Wellnitz worries the increased costs could force her to drop her insurance and just paying the penalty.
"I never thought I would say 'yes,' but I think that might be a reality," she said.
The Washington State Insurance Commissioner will approve the new rates next week, and the exchange's open enrollment starts November 1.
If the Silver plans are too expensive, the Washington Healthplanfinder encourages people to shop around on the exchange to make sure you know your options.