Tri-Cities area residents will see some of the largest increases in health insurance costs in the state if they buy their own Affordable Care Act health insurance, according to information from Sen. Maria Cantwell, D-Wash. For some people, costs are expected to more than double.

The roughly 300,000 Washingtonians who buy health insurance through the state’s online marketplace are set for a rude awakening as they begin shopping for plans. That’s because premiums for individual insurance bought on the Washington Health Benefit Exchange through the Affordable Care Act are set to rise an average of 21% next year.

There are real people suffering from the shutdown,” U.S. Rep. Michael Baumgartner, R-WA, told reporters on Oct. 19.

An estimated 80,000 Washington residents could be left unable to afford health coverage if Congress does not extend the enhanced premium tax credit.

Washingtonians who buy their insurance on the exchange are grappling with premium spikes and considering forgoing insurance.

Many states have shown rising premiums ahead of open enrollment for Affordable Care Act plans. The government shutdown is driven by Democrats and Republicans being far apart on the issue of extended subsidies.

When changes to the federal Medicaid program take effect in about a year, rural hospitals could face closures, leaving people to drive an hour or more to the next closest options.