Average 21% rate increase approved for Washington’s 2026 Exchange health insurance market

OLYMPIA, Wash. — Twelve health insurers have been approved to sell individual health plans in Washington’s Exchange in 2026. Wellpoint Washington is new to the individual health insurance market and will sell Exchange plans in Grays Harbor and King counties. 

Insurers requested a 21.2% rate change, and 21% was found to be actuarially justified. The plans and their rates will be reviewed for certification by the Washington Health Benefit Exchange Board at its Thursday, Sept. 11, meeting.

“Another year of increased premiums will be hard to hear for the thousands of Washingtonians who buy their own health coverage,” Insurance Commissioner Patty Kuderer said. “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 individual health insurance market is where people shop for a health plan if they do not get coverage from their employer, are self-employed, or are early retirees. Small employers also rely on this market to make coverage available to their workers. 

Last year, nearly 300,000 Washingtonians bought individual health plans through Washington’s Exchange, wahealthplanfinder.org, and 75% qualified for federal premium tax credits.  

Approximately 216,375 individuals with coverage from Washington’s Exchange qualified for help through the federally financed Enhanced Premium Tax Credits this year. These credits, which helped decrease enrollees’ average annual premium costs by $1,330, will expire at the end of the year if Congress fails to act. Kuderer has been strongly urging Congress to renew them before they expire.

According to the Exchange, 80,000 people are expected to drop coverage if the credits are not extended. Health insurers base their rate changes, in part, on what they expect to happen to their costs in the future — including how many people they expect to cover, their age and their health status, and how much they expect the costs of health care services to increase.  

“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,” added Kuderer. “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.”  

Health insurers listed several factors impacting their rate requests this year, including:

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

The Office of the Insurance Commissioner (OIC) reviews the benefits provided by an insurer’s individual health plan and the proposed rate changes to ensure they are reasonable in relation to the benefits they are providing. State law requires the OIC to accept a change if the company proves it is actuarially justified.