Affordable Care Act insurance costs to rise steeply again in WA

A quarter million Washingtonians who get their insurance through the state's exchange under the Affordable Care Act face another year of double-digit rate increases.

Health insurance rates will rise an average of 22.2% starting Jan. 1, Insurance Commissioner Patty Kuderer announced Wednesday. This comes after thousands dropped coverage due to the expiration of federal tax credits, the debate over which led to a lengthy government shutdown last fall.

This insurance option is meant for people not covered through their work or government programs like Medicaid or Medicare, like those who are self-employed or retired early. Small businesses with fewer than 50 employees also use the Washington Health Benefit Exchange, for their workers. About 250,000 people are enrolled this year in the exchange.

Thirteen insurers had requested an average 22.4% rate hike for 2027, which Kuderer is required to approve if the increase is actuarially justified. Premiums rose 21% this year, partly due to the end of the tax credits, which began during the COVID pandemic.

The 2027 hike is mainly due to rising costs of healthcare and enrollees' more robust needs, Kuderer said.

"This is, unfortunately, a reflection of the increasing cost of care," Kuderer said in a statement. "Families shouldn't experience sticker shock every year when shopping for health insurance, but these pressures are likely to continue without changes that slow health care spending, improve affordability and keep more people covered."

Insurance companies cited a few reasons for the steep increase. For one, the end of the tax credits makes coverage less affordable, meaning healthier people who need less care dropped their insurance. This raises the costs for those who stay on their health plans.

Other issues leading to the rate hike include health care organizations charging more for services and prescription drugs and members using more of these services, according to Kuderer's office.

Jim Freeburg, executive director of the Patient Coalition of Washington, said the increases will have "real consequences for the Washington families and small businesses that purchase their coverage through the Exchange."

"It's going to cost my wife and I over $36,000 to cover ourselves and our two girls and that's simply unfair for the coverage we'd get," Freeburg said in an email.

The rates are used to determine monthly premiums.

On the low end, the 16,000 members on Regence BlueShield plans will see an average 6.7% increase. For the more than 40,000 people on Kaiser Foundation Health Plan of Washington it will be around 14.1%. Community Health Plan of Washington, with nearly 37,000 enrollees, was approved for a 30.5% hike while the 98,000 covered by the Coordinated Care Corporation face a more than 25% jump.

The Washington Health Benefit Exchange Board is set to certify the rates at its Thursday meeting. Open enrollment opens Nov. 1, and lasts until Jan. 15.

One other insurer not on the exchange, Asuris Northwest Health, is awaiting an approved rate change for its roughly 800 enrollees in Washington. It requested a 14.9% increase.

Enrollment in the exchange this year is down roughly 36,500 from 2025, a nearly 13% reduction, the biggest falloff since the marketplace launched in 2013. State officials had feared an even larger dropoff when the tax credits went away.

Rural counties saw some of the steepest declines, but the state's own premium assistance, known as Cascade Care Savings, helped avert some of the more dire notions of the drops in coverage.

Those most likely to drop their coverage were young and lower-income. Many of those no longer covered could've found insurance elsewhere, like joining a family member's plan or getting employer-sponsored coverage.

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