WA health insurance premiums soar due to federal fallout, rising costs

Rates for Washington’s health insurance exchange are expected to see a huge jump for the 2026 plan year.

The increases will impact more than 300,000 across the state who are self-insured, self-employed, early retirees or who work for certain small businesses, according to the Washington Office of the Insurance Commissioner.

Rates are expected to increase by an average of 21% for 2026. That’s nearly double last year’s increase of 10.7%, according to the office’s website.

Employer-sponsored plan rates are also expected to increase next year, though not as drastically as their marketplace counterparts.

Senator Maria Cantwell, D-Wash., estimated state residents using the marketplace will be hit with an average increase of more than $1,500 annually.

“Many Washingtonians found out today that they will be forced to pay an average of $129 per month or $1,548 per year more next year for the same health care coverage they are already getting,” Cantwell said in a news release.

“These price spikes are driven largely by Congressional Republicans choosing to not extend the Affordable Care Act enhanced premium tax credits in their ‘Big Beautiful Bill,’” she said.

“The Republican Budget Bill will also trigger massive cuts to Medicaid, leaving around 300,000 Washingtonians without healthcare coverage, forcing rural hospitals to close, and cutting critical addiction treatment and senior care programs,” Cantwell continued. “Denying Americans critical and potentially lifesaving medical treatment to pay for tax cuts for the ultra-wealthy is not only wrong, it will end up costing us a lot more in the long run.”

The spending package included $50 billion in funding for rural hospitals through 2030. Washington state is expected to receive at least $100 million annually out of that funding, and may be eligible for more.

More than 24 million people nationwide get their insurance through a marketplace.

On top of that, more than 216,000 people, or 72% of those using the marketplace, are expected to lose Enhanced Premium Tax Credits worth an average $1,330 in premiums cost savings set to expire this year.

The state estimates about 80,000 people are at risk of losing coverage without those credits.

Cantwell’s news release said these expected increases have left small business owners in a bind, having to decide how much of that cost they’ll need to pass on to employees.

She also expects that these increases and loss of coverage will lead to people putting off care, placing greater stress on already overburdened emergency rooms. In turn, that also will lead to higher costs for hospitals.

Prices are also set to increase private insurance through workplaces.

A national survey of employer-sponsored health plans said last week that employers are preparing for the biggest increase in health insurance costs in 15 years.

The survey said employer-sponsored plans are expected to jump an average of 6.5% after cost-reduction measures. Without those attempts to offset costs, rates could jump up to 9% for people who get insurance through their workplace.

Franklin County commissioners heard from staff Wednesday during a scheduled discussion that they were expecting a significant increase, but hoped it wouldn’t be double digits.

Insurance Commissioner Patty Kuderer has been urging Congress to renew the credits, which were not part of the “One Big Beautiful Bill” spending package approved earlier this summer.

The credits could be saved by lawmakers as part of upcoming negotiations to avoid a federal shutdown.

Why are rates going up?

Rates on the marketplace are determined by what insurers expect to happen to their future costs, according to the news release. Those costs can change based on the expected number of people seeking coverage, age, health status and how much insurers expect costs of health care to increase.

Kuderer said federal uncertainty is playing a big part.

“Another year of increased premiums will be hard to hear for the thousands of Washingtonians who buy their own health coverage,” Kuderer said in the news release. “But, when the insurers prove they need a rate change, we’re required by state law to accept it. And this year insurers pointed to ongoing uncertainty coming from the federal government and the surging costs of health care.”

The news release said health insurers pointed to several factors to justify their rate requests this year, including:

• Uncertainty about whether the federal government will extend the tax credits that are set to expire
• Rising health care and prescription drug costs
• Increases in the number of people using services
• Hospital consolidation
• Higher rates paid to health care facilities and providers

“We know from experience that when premiums become less affordable, younger and healthier people drop coverage and those who need care find a way to keep it,” Kuderer said.

“This cycle is hard for the system to bear and even harder for consumers to endure. The state Legislature is considering options to increase the affordability of health care, but it’s more urgent than ever that we start seriously moving towards universal coverage. We cannot afford to wait.”

What to expect

Marketplace rates are expected to increase between 6% and 38% depending on the insurer.

The lowest increase is from Kaiser Foundation Health Plan of the Northwest at an expected average of 6.1%. That plan insures about 7,000 people. Their other plan, Kaiser Foundation Health Plan of Washington insures more than 40,000 people and is expected to increase by an average 9.8%.

Coordinated Care Corporation is the largest provider on Washington’s marketplace with more than 107,000 customers. Their rate will increase by an average 26.9%.

State law requires the Washington Health Benefit Exchange Board to approve rate changes that insurers prove are justified. The board is expected to review the rate changes for certification on Thursday, Sept. 11.

Open enrollment for the marketplace begins Nov. 1.

This story was originally published September 10, 2025 at 12:18 PM with the headline "WA health insurance premiums soar due to federal fallout, rising costs."