Washington health insurance Marketplace guide

To be eligible to enroll in private health coverage through Washington Healthplanfinder, you must:⁹

• Live in Washington
• Not be incarcerated
• Not be enrolled in Medicare

Under the ACA, a person must also be lawfully present in the U.S. to use the exchange/Marketplace in any state. But Washington obtained federal permission to allow undocumented immigrants to enroll in health plans through Washington Healthplanfinder starting with the 2024 plan year. The approval is effective through 2028,¹⁰ but could be extended in the future.

Undocumented immigrants are not eligible for federal subsidies, but Washington Healthplanfinder can provide them with state-funded Cascade Care Savings subsidies if their income doesn’t exceed 250% of the poverty level.¹⁰

A federal rule change took effect in November 2024, allowing DACA recipients to enroll in the Marketplaces nationwide, with access to the same income-based federal subsidies that are available to U.S. citizens and lawfully present residents. But a new rule change revoked that access as of August 25, 2025.

DACA recipients can still use Washington Healthplanfinder (which isn’t the case for other state-run Marketplaces or HealthCare.gov) because Washington has federal permission for undocumented immigrants to use the Marketplace. But they are no longer eligible for federal subsidies due to the 2025 rule change¹¹ (state-funded subsidies are still available).

In addition to basic enrollment eligibility, additional parameters must be met to qualify for financial assistance. To be eligible for income-based federal Advance Premium Tax Credits (APTC), state-funded Cascade Care Savings (state subsidies), or federal cost-sharing reductions (CSR), you must:

• Not have access to an affordable plan offered by an employer. If you are eligible to sign up for an employer’s plan and aren’t sure whether it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies for a plan obtained through Washington Healthplanfinder. 
• Not be eligible for Apple Health (Medicaid/CHIP).
• Not be eligible for premium-free Medicare Part A.¹²
• File a joint tax return with your spouse, if you’re married.¹³ (with very limited exceptions)¹⁴
• Not be able to be claimed by someone else as a tax dependent.¹³

Beyond those basic requirements, premium subsidy eligibility depends on your household’s income and how it compares with the cost of the second-lowest-cost Silver plan in your area – which depends on your age and location. 

In Washington, the open enrollment period begins November 1 and continues through January 15 each year. Enrollments completed by December 15 will have coverage effective January 1, whereas enrollments completed between December 16 and January 15 will have coverage effective February 1.¹⁵

However, open enrollment will become shorter starting in the fall of 2026. At that point, for coverage effective in 2027 and future years, the enrollment window will not be allowed to extend past December 31, and all plans selected during open enrollment will take effect January 1.

After the open enrollment period ends, you may still be able to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage. And Native Americans can enroll year-round, without a specific qualifying life event. 

Enrollment in Washington’s Apple Health (Medicaid) is available year-round for eligible applicants.

To enroll in an ACA Marketplace/exchange plan in Washington, you can: 

• Visit Washington Healthplanfinder – the state’s health insurance exchange – to compare the health plans that are available in your area, determine whether you’re eligible for financial assistance (including federal subsidies and Washington’s Cascade Care Savings), and enroll in coverage during open enrollment or during a special enrollment period. 
• Enroll in coverage through Washington Healthplanfinder with the help of an insurance agent or broker, or an exchange-certified Navigator.
  

You can reach Washington Healthplanfinder’s customer service team at 855-923-4633 (TTY/TDD: 855-627-9604). They are available Monday through Friday, 7:30 am to 5:30 pm.

When you enroll in a health plan through Washington Healthplanfinder, you may find that you’re eligible for premium subsidies under the ACA. And for those with income up to 250% of the federal poverty level, the assistance may be more robust than it is in many other states, as both federal and state subsidy programs are available in Washington.

The state-funded subsidy program is called Cascade Care Savings. It’s available to enrollees who select a Silver or Gold Cascade Care plan through Washington Healthplanfinder.

For 2026, most applicants with household income up to 250% of the federal poverty level will get an additional $55 per member per month from the Cascade Care Savings program, which will reduce their premium costs. This is a smaller amount than the program provided in 2025, but the state’s new approach of premium alignment (silver loading, which increases the cost of Silver plans and thus results in larger federal premium subsidies) will ensure that Gold Cascade Care plans remain affordable.⁶

Applicants with eligible income who aren’t eligible for federal subsidies (including undocumented immigrants) will get $250 per member per month in Cascade Care Savings.

Nearly 73% of Washington Healthplanfinder enrollees qualified for APTC during the open enrollment period for 2025 coverage. These subsidies covered an average of $469/month, reducing the average APTC-eligible enrollee’s net premium to about $173/month.¹⁶

Source: CMS.gov¹⁷

Applicants with household income up to 250% of the federal poverty level are also eligible for federal cost-sharing reductions (CSR), which will reduce the deductible and other out-of-pocket expenses for Silver-level plans. Nearly four out of ten Washington Healthplanfinder enrollees were receiving CSR benefits as of 2025.³

And as noted above, Washington is among the states where additional state-funded subsidies are available. Starting in 2023, Washington began offering state-funded premium subsidies for applicants with income up to 250% of the poverty level, as long as they select a Cascade Care Silver or Gold plan. The Cascade Care Savings are available in addition to the federal premium subsidies and cost-sharing reductions.¹⁸ 

(Note that federal APTC can be used with any metal-level plan, federal CSR is available with any Silver-level plan, and Cascade Care Savings are available with Silver or Gold Cascade Care plans. To receive all three benefits at once, an eligible enrollee would need to have income up to 250% of the poverty level and select a Silver Cascade Care plan.)

Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Apple Health (Washington Medicaid). Learn more about whether you might be eligible for Medicaid in Washington.

Starting in July 2024, a limited number of undocumented immigrant adults in Washington were able to enroll in Medicaid (Apple Health) if their income wasn’t more than 138% of the federal poverty level.¹⁹ This coverage is free, whereas the Marketplace coverage for undocumented immigrants averages about $210/month after the state-funded subsidies are applied.²⁰

But the state only had enough funding to provide Apple Health coverage to 13,000 undocumented immigrants, and that enrollment cap was reached within just a couple of days. Undocumented residents can still apply and be put on a waiting list in case spots open up.²¹

Apple Health sought additional funding from the state legislature, to further expand Apple Health coverage for undocumented immigrants.²² But although the budget that was approved in 2025 did continue funding for Apple Health Expansion, it kept that funding at the existing level.²³

Twelve insurers are offering Marketplace coverage for 2026 in Washington, including one newcomer:²⁴

• BridgeSpan Health Company
• Community Health Plan of Washington
• Coordinated Care Corporation
• Kaiser Foundation Health Plan of the Northwest
• Kaiser Foundation Health Plan of Washington
• LifeWise Health Plan of Washington
• Molina Healthcare of Washington
• Premera Blue Cross
• Regence BlueCross BlueShield of Oregon
• Regence BlueShield
• UnitedHealthcare of Oregon
• WellPoint Washington, Inc. (new for 2026)

There were 12 participating insurers in 2024, but PacificSource (which offered Marketplace plans in four counties in 2024, and was the only carrier that offered PPO plans²⁵) exited the Washington market at the end of 2024.²⁶ 

So there were 11 participating insurers for 2025. All of them are continuing to offer plans in 2026, plus one new insurer (Wellpoint Washington), bringing the number of participating carriers back to a dozen.

For 2026, the following average rate increases were approved for the insurers that offer individual/family coverage offered through Washington Healthplanfinder, amounting to an overall average rate increase of 21% (before subsidies are applied):²⁴

Source: Washington Office of the Insurance Commissioner²⁴

It’s important to note that average rate changes apply to full-price premiums, and most enrollees do not pay full price. These subsidies change each year to keep pace with the cost of the second-lowest-cost Silver plan in each area. But for 2026, federal subsidies will be designed to require enrollees to pay a larger share of the premium themselves, if Congress doesn’t extend the federal subsidy enhancements that are scheduled to expire at the end of 2025. (As of early December 2025, Congress had not extended the subsidy enhancements.)

Washington has adopted a new premium alignment (silver loading) approach for 2026, helping to “preserve consumer affordability and stability in Washington state’s individual health insurance market.”²⁷

Under the state’s new rules, insurers must add a 43.5% load to the premiums for on-exchange Silver plans,²⁸ to account for the cost of cost-sharing reductions and the assumption that the only people who will select Silver plans have income that doesn’t exceed 200% FPL (meaning they’re eligible for the strongest cost-sharing reduction benefits). This has the effect of raising Silver plan premiums relative to other metal levels. This increases premium subsidies, since subsidy amounts are based on the cost of Silver-level coverage.

Stakeholders note that although Washington’s state-funded premium subsidies are smaller for 2026 than they were for 2025, and although Congress has not extended the federal subsidy enhancements, people eligible for both federal subsidies and state-funded subsidies “will continue to have access to affordable net premiums”⁶ due to the new premium alignment approach.

For perspective, here’s an overview of how average full-price premiums have changed in Washington’s individual/family market over the years:

• 2015: Average increase of 1.9%²⁹
• 2016: Average increase of 4.2%³⁰
• 2017: Average increase of 13.6%³¹
• 2018: Average increase of 36.4%³²
• 2019: Average increase of 13.6%³³
• 2020: Average decrease of 3.3%³⁴
• 2021: Average decrease of 3.2%³⁵
• 2022: Average increase of 4.17%³⁶
• 2023: Average increase of 8.18%³⁷
• 2024: Average increase of 8.9%³⁸
• 2025: Average increase of 10.7%³⁹

During the open enrollment period for 2025 coverage, Washington Healthplanfinder enrollment reached a record high, with 308,227 people selecting plans through the Marketplace.¹⁶ This was the first time the state’s enrollment had exceeded 300,000 people.⁴⁰ (See below for a chart of enrollment in previous years.)

The record-high enrollment in recent years (which mirrored national trends) was due to the continued enhancement of premium subsidies under the American Rescue Plan and Inflation Reduction Act, as well as the “unwinding” of the pandemic-era Medicaid continuous coverage rule. CMS reported that more than 89,000 Washington residents transitioned from Medicaid (Apple Health) to Marketplace coverage during the “unwinding” process.⁴¹

Source: 2014,⁴² 2015,⁴³ 2016,⁴⁴ 2017,⁴⁵ 2018,⁴⁶ 2019,⁴⁷ 2020,⁴⁸ 2021,⁴⁹ 2022,⁵⁰ 2023,⁵¹ 2024,⁵² 2025¹⁶

Washington Healthplanfinder
The state-based health insurance exchange, where individuals and families can enroll in health plans and receive subsidies based on household income. Washington Healthplanfinder is also the enrollment portal for income-based Apple Health (Medicaid) and CHIP enrollment.

Washington State Office of the Insurance Commissioner
Licenses and regulates the state’s health insurance companies, brokers, and agents. Provide assistance and information to consumers who have questions or complaints about regulated entities.

Washington Statewide Health Insurance Benefits Advisors (SHIBA)
A local service that can answer questions and provide information, counseling, and assistance related to Medicare in Washington.