21% Confirmed for 2026 Exchange Health Insurance Plans in WA State

Regulators found the 21% request “actuarially justified.”

In May, carriers asked for an average 21.2% hike. The Office of the Insurance Commissioner has now approved an average 21% increase for 2026 Exchange plans. We wrote about this back in May, and we had actually expected the final average rate to come down (though remain historically high). It turns out that although there were changes by carrier, the approved average remained the same.

What changed since May

Several carriers were approved well below what they asked: Kaiser Foundation Health Plan of Washington went from 19.2% requested to 9.8% approved (−49%, affecting 40,000 individuals), BridgeSpan from 18.4% to 10.0% (−46%), and Community Health Plan of Washington from 27.6% to 21.1% (−24%). A few moved above their request: Coordinated Care from 22.0% to 26.9% (+22%, covering about 108,000 people) and Molina from 24.6% to 28.3% (+15%). The regulator explains that changes follow an actuarial review and that it must accept a rate “when the insurers prove they need” it and when it is “actuarially justified.” For more carrier-by-carrier details, see the OIC table linked in the recent release.

Keep in mind, these are individual market rates. Group plans are filed and approved on different timelines. The individual market often signals next-year pressure, but it is not a one-to-one predictor for employer plans.

Insurance Commissioner Patty Kuderer, “Another year of increased premiums will be hard to hear… But, when the insurers prove they need a rate change, we’re required by state law to accept it.”

Who is affected

This applies to the individual market on the WA Health Benefit Exchange. Nearly 300,000 residents bought individual plans last year. About 75% received federal premium tax credits, with 216,375 benefiting from enhanced credits that lowered average annual premiums by $1,330. The Exchange has warned that up to 80,000 could drop coverage if the enhanced credits lapse.

Why the increase is so steep

Regulators and carriers point to several pressures: higher medical and prescription drug costs, more people using services, hospital consolidation, higher provider payments, and uncertainty around expiring enhanced ACA tax credits.

“Not knowing what’s going to happen… is having an impact on these increases… insurers have built that uncertainty into their request.” – Patty Kuderer, as quoted last week.

Why BHT exists and what employers can do

These events serve as a reminder of why Business Health Trust exists and the opportunity we offer employers to attract and keep talent, control costs, and keep teams healthy. We pool buying power, so small teams get big-company coverage and rates they wouldn’t normally have access to, with scale across 1,200+ employers and 80+ medical plan designs. Most BHT medical plans include Nice Healthcare, giving employees $0 primary care plus same-day virtual access to mental health and physical therapy, and 550+ common medications at no cost when prescribed by Nice. In many WA areas, labs, X-rays, and other services can even happen at home or work.