Washington Approves Average 22.2% Rate Increase for 2027 Exchange Health Plans

Washington — Average 22.2% rate increase approved for Washington’s 2027 Exchange health insurance market: Twelve health insurers have been approved to sell individual health plans in Washington’s Exchange in 2027.

Insurance companies requested a 22.4% rate change, and 22.2% was found to be actuarially justified. 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.

The uptick in 2027 is due mainly to an increase in the basic costs of health care and more robust health care needs among the people covered by individual health plans.

The Insurance Commissioner is required by law to approve rate increases when insurance companies can prove the change is justified.

“This is, unfortunately, a reflection of the increasing cost of care,” Insurance Commissioner Patty Kuderer said. “Families shouldn’t experience sticker shock every year when shopping for health insurance, but these pressures are likely to continue without changes that slow health care spending, improve affordability and keep more people covered.”

Kuderer’s actuarial staff identified four main factors driving the increase, based on companies’ rate filings:

Healthcare organizations are charging more for services and prescription drugs.

Members are using more healthcare services and shifting towards higher-cost services.

People who have left, or are expected to leave, the market tend to be healthier than those who keep their coverage. This leads to higher average health care needs.

The expiration of the Enhanced Premium Tax Credits makes coverage less affordable, which prompts healthier people — those less likely to need health services — to drop their coverage. Losing these members raises the average costs of covering those who stay.

The plans and their rates will be reviewed for certification by the Washington Health Benefit Exchange Board at its Thursday, Sept. 10 meeting.

People who don’t receive health coverage through their employer shop for a health plan on the individual health insurance market. This also includes self-employed people and early retirees. Small businesses with fewer than 50 employees also rely on the Exchange to provide health coverage for their workers.

Fourteen insurers offered individual plans for 2026. Providence Health Plan, which covered 254 enrollees, will not offer coverage in 2027.

Asuris Northwest Health, which requested a 14.9% increase, only offers its plans outside of the Exchange. Its rate has yet to be approved.

Nearly 250,000 Washington residents bought individual health plans through Washington’s Exchange, wahealthplanfinder.org, in 2026 — 13% fewer than a year before. It was the largest drop in enrollment since 2012, due in part to Congress’ failure to extend the Enhanced Premium Tax Credits late last year. Those credits had helped cut enrollees’ average annual premium costs by $1,330.

Source link: Washington Department of Insurance — https://bit.ly/46ZuASb