Last spring, something incredible happened: After a decade of gridlock, Congress finally passed a bill that recognizes the enormous strain of health care costs on family and state budgets. Born out of the COVID-19 crisis, the American Rescue Plan Act included direct relief through 2022 for the monthly premiums Washington residents face when they buy their insurance through Washington Healthplanfinder, the state-based marketplace administered by the Washington Health Benefit Exchange.

As health care leaders in the state Legislature, we welcomed this long overdue step toward health care affordability. We’ve worked hard in the last decade to make health care available to more Washington residents — nearly 95% of our residents have coverage now, people are visiting the doctor more and life expectancy has risen. We’re proud of steps we’ve taken in recent legislative sessions to make coverage more affordable: Wee created Cascade Care, the nation’s first public option, which is expanding coverage options and lowering deductibles and out-of-pocket costs; appointed a board to investigate health care costs; and are launching new premium assistance programs, including a pilot that will offer free health coverage to low-income child care workers this fall to support their essential work during the pandemic.

But we can’t drive down health care costs through state action alone. At the start of the pandemic, we asked for help from our colleagues in Congress to address the health care affordability crisis, and they delivered a critical short-term fix. The temporary premium assistance Congress authorized in the American Rescue Plan Act has had astonishing results: Half of customers buying their own coverage through the state exchange now pay less than $100 a month for health coverage. More than 34,000 people who lost jobs or had very low income during the pandemic are getting coverage for $1 or less. The number of new Exchange customers has doubled over the last few months, as Washingtonians who couldn’t previously afford coverage are now finding that premiums are finally within reach, leading to more and more people signing up for coverage. Experience has shown that premium costs are the most critical factor determining whether someone will sign up for coverage through the exchange. It is vital to make premiums as affordable as possible for those in this market.

Now Congress will decide whether to keep that progress or return to a time when one in every seven people buying coverage through the exchange had to spend more than 10% of their total income to afford a basic plan. Congress is in the final stages of negotiating a federal budget package that could include the permanent extension of the ARPA premium assistance program, alongside other critical priorities such as adding dental, hearing and vision to Medicare benefits; negotiating lower prices from drug companies; and closing health equity gaps. We recognize the challenges that Washington’s Sen. Patty Murray and other congressional budget leaders are facing as they try to move the package ahead with only a razor-thin majority. But the time to act is now.

If Congress allows the ARPA relief to expire, premium payments could double for millions of Americans next year. Here in Washington, thousands of our residents would be hit again with unaffordable premiums as they try to rebuild their health and economic security coming out of the pandemic. And state budget writers would have to try to find a way to fill the gap, threatening our ability to direct limited state dollars where they are needed most, such as addressing high deductibles and expanding care for immigrants who are essential workers but left out of federal programs.

Congress has a once-in-a-decade opportunity to make good on what we’ve learned from the pandemic: our economy and families cannot thrive when affordable health care is out of reach. We’re going to keep working in Olympia to tackle underlying health care costs through a stronger public option and other reforms. We urge our counterparts in the other Washington to do their part by delivering the lasting premium relief Washington state residents need.