Recent figures from the state Medicaid exchange indicate that around 40,000 fewer residents of Washington are enrolled compared to last year at this same time.
OLYMPIA, Wash. — The Washington State Association notes that despite increasing challenges in enrollment and affordability, current insurance coverage through the Washington Health Benefit Exchange—which includes access to Medicaid, commonly known as Apple Health—is expected to persist through the next legislative session.
Looking ahead to the 2027 legislative session, advocates and lawmakers are preparing significant proposals. Senate Bill 5947, pitched as a “starter” for universal healthcare, was stalled in Olympia this year. It aimed to lay the groundwork for a state-operated plan that would provide comprehensive coverage to all state residents.
Even though the bill failed to advance in the House by a critical deadline, proponents argue that the groundwork laid over the past two years will lead to a stronger effort down the line.
A federal law set to take effect in 2025 allows states to pursue waivers aimed at merging funding from programs like Medicaid and Medicare into a single, state-managed system, so long as the coverage adheres to federal guidelines.
The decline in enrollment is linked to rising costs
At the same time, Washington’s healthcare system is beginning to show signs of stress.
The latest data from the exchange’s upcoming Spring 2026 report reveals that roughly 40,000 fewer Washingtonians are enrolled than at this point last year, according to officials.
Currently, about one in four residents in Washington receive their insurance through Washington Healthplanfinder.
Officials point to the expiration of enhanced premium tax credits and other federal policy shifts as the main reasons for this downturn. For instance, the exchange previously estimated that this expiration could raise costs by about $1,000 a month for a married couple in King County earning $120,000 annually.
“Those who are still enrolled in the exchange are grappling with an affordability crisis,” remarked Laura Kate Zaychkin, the director of market competition and affordability for the exchange.
This year, around 50,000 fewer people in Washington will receive tax credits, and the exchange anticipates a loss of approximately $275 million in enhanced federal aid.
Despite some mitigation efforts from government partners, officials have warned that enrollment could drop by as much as 30% over the next few years, potentially leaving many individuals without insurance.
Recent federal changes to Medicaid, signed by President Trump, are set to further impact coverage in 2027 with new work requirements, stricter criteria for tax credits, and a halt to automatic renewals during open enrollment periods.
The nonpartisan Congressional Budget Office estimates that Medicaid expenditures will be reduced by $911 billion by 2034, potentially resulting in 10 million more Americans being uninsured during that timeframe.
