OLYMPIA, Wash. — Fourteen health insurers have requested an average rate change of 21.2% for Washington state's 2026 Individual Health Insurance Market. Insurers base their requested rate changes on assumptions they make about the services their policyholders will use and the cost to deliver that care. The health plans and proposed rate changes are currently under review by the Office of the Insurance Commissioner.
Wellpoint Washington, Inc. is new to the market and plans to sell in Grays Harbor, King and Spokane counties.
A factor impacting the requested increase this year is that the Enhanced Advance Premium Tax Credits are set to expire on Dec. 31, 2025, unless Congress renews them. While the premium subsidies provided under the Affordable Care Act help many people qualify for coverage, a significant number of people still struggle to afford coverage. Enhanced tax credits were created under the American Rescue Plan Act in 2021, and extended through 2025 by the Inflation Reduction Act, to help people who make more than 400% of the Federal Poverty Level ($62,600) afford coverage and increase the amount of help for people who make less than that.
According to the Washington Health Benefit Exchange, as many as 80,000 people will drop coverage if the subsidies are not extended. Health plans took this into account when creating their request for 2026. Based on the assumptions in the initial requested rate changes, renewing the tax credits could reduce the proposed rate changes by as much as 6.4%. Washington state Insurance Commissioner Patty Kuderer advocated for an extension of these tax credits while in Washington, D.C. earlier this month for the National Association of Insurance Commissioners (NAIC) 2025 Commissioner Fly-In.
"These tax credits are how many people afford critical coverage that protects themselves and their families," said Kuderer. "I know many members of Congress understand this and hopefully, they will prevail in these negotiations. Thousands of people in Washington state and millions across the country depend on the individual market and can't afford to see prices rise unnecessarily."
Most people get health coverage through their jobs, but more than 300,000 people in Washington do not have employer-sponsored health insurance and must buy a plan in the individual market. Last year, 286,526 people bought through the Exchange and 77% qualified for either federal premium tax credits or state-funded Cascade Care Savings.
| Company name | Sold on Exchange, off Exchange or both | Number of people impacted | Requested average rate change |
|---|---|---|---|
| Asuris Northwest Health | Off Exchange | 964 | 15.1% |
| BridgeSpan Health Company | On Exchange | 376 | 18.4% |
| Community Health Plan of Washington | On Exchange | 34,463 | 27.6% |
| Coordinated Care Corporation | On Exchange | 107,649 | 22.0% |
| Kaiser Foundation Health Plan of the Northwest | Both | 7,000 | 11.4% |
| Kaiser Foundation Health Plan of Washington | Both | 40,266 | 19.2% |
| LifeWise Health Plan of Washington | On Exchange | 23,346 | 14.4% |
| Molina Healthcare of Washington, Inc. | On Exchange | 43,346 | 24.6% |
| Premera Blue Cross | On Exchange | 9,460 | 18.8% |
| Providence Health Plan | Off Exchange | 254 | 10.6% |
| Regence BlueShield | Both | 21,878 | 9.6% |
| Regence Blue Cross Blue Shield of Oregon | Both | 10,029 | 24.9% |
| UnitedHealthcare of Oregon, Inc. | Both | 6,180 | 37.3% |
| Wellpoint Washington, Inc. | Both | New | New |
| Total | 305,592 | 21.2% |