Washington Health Insurance Guide

Health Insurance Overview in Washington

Washington operates Washington Healthplanfinder, a state-based marketplace. Washington expanded Medicaid (Apple Health) in 2014 and has one of the lower uninsured rates in the nation. Washington created Cascade Care — a state public option plan — in 2021, making it one of the first states with an active state public option on the marketplace.

Average Health Insurance Costs in Washington

Marketplace Enrollment in Washington

Washington residents can enroll in individual and family health insurance plans through Washington Healthplanfinder (State-Based). Open enrollment runs November 1 – January 15 (Washington Healthplanfinder).

Average Premiums by City in Washington

Medicaid in Washington

Apple Health (Washington Medicaid) covers adults with incomes up to 138% of the federal poverty level. Washington has comprehensive Medicaid benefits.

Children's Health Insurance (CHIP) in Washington

Apple Health for Kids covers children up to 312% of the federal poverty level.

What Makes Washington Unique

Washington's Cascade Care program includes Cascade Select, one of the first state public option health plans in the nation — plans contracted by the state that compete with private plans on the Washington marketplace. Cascade Care plans must meet specific network and cost-sharing requirements. Washington's experience with a public option is being closely watched by other states considering similar programs.

ACA Subsidies: What Washington Residents Should Know

The enhanced subsidies first enacted in the American Rescue Plan expired at the end of 2025. For 2026, premium tax credits follow the original ACA rules: there is no credit above 400% (the “subsidy cliff”), and enrollees are expected to pay up to 9.96% of income toward the benchmark Silver plan. House in January 2026 but has not become law, so 2027 plans are being priced and subsidized under the same rules unless Congress acts.

Cascade Care, Cascade Select, and Cascade Care Savings

Three similar names mean three different things on Washington Healthplanfinder:

About 90% of Healthplanfinder enrollees chose a Cascade Care plan for 2026. If your income is under 250% FPL, picking a non-Cascade plan forfeits the state savings, so check the plan label before choosing.

Premium Alignment: Why Gold Can Cost Less Than Silver

Starting in 2026, Washington requires “premium alignment” — insurers price Silver plans higher to reflect the cost-sharing reductions they must fund. Because the federal credit is pegged to the second-lowest-cost Silver plan, raising Silver prices raises everyone’s credit.

The result for subsidized enrollees: the larger credit applied to a Bronze or Gold plan can make those plans unusually cheap, and in some counties a Gold plan costs less after subsidies than a Silver plan. If your income is above 250% FPL (where cost-sharing reductions no longer apply), compare Gold first. Below 250%, an enhanced Silver plan with cost-sharing reductions usually still offers the best value because of its lower deductible.

2026 Prices and What to Check for 2027

• Full-price premiums rose about 21% on average for 2026, with 12 insurers participating.
• Immigrant coverage: Washington’s 1332 waiver lets residents enroll regardless of immigration status. DACA recipients lost federal subsidy eligibility in August 2025 but can still receive state assistance.
• Enrollment dates for 2027 were in flux this year because of a federal rule later vacated by a court; open enrollment begins November 1, 2026 — confirm the closing date on Healthplanfinder before you plan around it.

Tips for Choosing Health Insurance in Washington

Washington residents should enroll through Washington Healthplanfinder and consider Cascade Care public option plans. Apple Health covers low-income adults. Seattle metro residents benefit from competitive insurer options including the public option. Apple Health for Kids provides comprehensive children's coverage up to 312% FPL.

• Enroll during open enrollment (November 1 – January 15 (Washington Healthplanfinder)) — missing the deadline means waiting until the next open enrollment unless you have a qualifying life event.

Frequently Asked Questions

What is Cascade Care Savings in Washington?

It is state premium assistance for households with income up to 250% of the federal poverty level who enroll in a Silver or Gold Cascade Care plan. For 2026 it is about $55 per member per month for most enrollees, on top of the federal premium tax credit.

What is the difference between Cascade Care and Cascade Select?

Cascade Care plans are standardized plans with set deductibles and copays. Cascade Select is Washington’s public option — Cascade Care plans contracted by the state. Both are sold on Washington Healthplanfinder.

Why is a Gold plan sometimes cheaper than Silver in Washington?

Washington requires premium alignment starting in 2026, which raises Silver prices and therefore raises the federal tax credit. That larger credit applied to a Gold plan can make it cheaper than Silver after subsidies, especially for people above 250% FPL who don’t receive cost-sharing reductions.

The information on this page is provided for general informational purposes only and reflects estimated industry averages and program eligibility rules as of 2026. Health insurance premiums, Medicaid eligibility thresholds, marketplace options, and program rules change annually. Always verify current eligibility and enrollment options at the official Washington Healthplanfinder (State-Based) or by contacting a certified navigator or broker. Premium figures shown are approximations before subsidies — actual net premiums depend on individual income, household size, and plan selection.