Washington health insurance enrollment hits record decline

Washington saw a nearly 13% decline in health insurance enrollment this year, marking the largest drop since the state’s insurance marketplace launched in 2012, according to a report released on Tuesday by the Washington Health Benefit Exchange.

About 250,000 Washingtonians selected or re-enrolled in a qualified health plan through Washington Healthplanfinder during the 2026 open enrollment period, down from more than 286,500 the year before, according to the report.

The losses were steeper than initially projected after Congress allowed enhanced premium tax credits to expire at the end of 2025. When open enrollment closed in January, about 40,000 fewer people had signed up compared with the prior year. But after factoring in who actually paid for coverage, an additional 14% of enrollees dropped out — roughly double the typical 7% to 10% attrition rate.

Health insurance enrollment drops as premium tax credits expire

The number of enrollees receiving federal premium tax credits fell to about 163,000 this year from nearly 215,000 in 2025. Sixty-five percent of qualified health plan enrollees now receive federal tax credits, down from 75% the year before.

The enhanced premium tax credits, first enacted during the COVID-19 pandemic and extended under the Inflation Reduction Act, expired at the end of 2025 after Congress declined to renew them.

“With the passage of H.R. 1 and the expiration of federal enhanced premium tax credits, many customers experienced a doubling or tripling of their premiums this year and faced hard decisions about whether to stay covered,” Tara Lee, the exchange’s chief of communications, said.

State programs helped cushion the blow. Cascade Care Savings and other premium assistance policies kept costs stable for lower-income enrollees, and about 68% of marketplace customers now receive some form of state or federal financial help.

The makeup of the marketplace is also shifting. With fewer subsidized customers, higher-income buyers now make up a larger share of the pool, and they’re choosing more expensive coverage. Gold-tier plans account for a majority of enrollments for the first time, at 52%, followed by bronze at 31% and silver at 17%.

Nearly half of all enrollees were assisted by navigators, brokers, or other enrollment assisters, according to the report.

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