Local drop in ACA coverage among highest in state

Pacific County experienced one of the sharpest declines in the state in insurance coverage under the Affordable Care Act this year, new figures show.

The number of local residents enrolled through the Washington Health Benefit Exchange decreased from 806 in 2025 to 626 in 2026. The 22.3% year-over-year decline is the fourth highest drop among Washington's 39 counties.

Statewide enrollment in the Affordable Care Act — also commonly referred to as the ACA or Obamacare — decreased by nearly 13% from last year, with about 36,500 fewer Washingtonians enrolled in 2026 compared to 2025. Neighboring Wahkiakum County saw a nearly identical 22.2% drop, while enrollment in Grays Harbor and Lewis counties declined by 16.6% and 12.5%, respectively.

The enrollment decline in the state coincides with Congress failing to extend subsidies that made health insurance plans more affordable for those who do not receive coverage through their employer or through government programs such as Medicare or Medicaid.

Pacific County also saw a decline in the number of people enrolled in Apple Health, Washington's Medicaid program. Medicaid is a joint federal and state program that provides government-sponsored health care to low-income Americans and people with disabilities.

Local enrollment in Apple Health declined from 5,233 in 2025 to 4,958 in 2026, a drop of 275 people — 5.3%. Nearly one-third (32.5%) of Pacific County's under-65 population is receiving coverage through Apple Health this year, 12th-highest in the state and well above the statewide rate of 23.2%.

The dip in Medicaid enrollment coincides with new work requirements approved by Congress as part of the One Big Beautiful Bill Act that was passed and signed into law last year.

Analysis in 2025 by the nonpartisan Congressional Budget Office projected that about 7.5 million people nationwide would lose Medicaid coverage because of changes under the law — namely due to the imposition of work requirements — while 2.5 million will lose Affordable Care Act coverage.