This week Washington's insurance commissioner, Patty Kuderer, approved an average 22.2% increase in premiums for individual health plans in 2027. Insurers had asked for 22.4%. The new rates take effect January 1, and they land on a market that already absorbed a 21% increase this year.
"This is, unfortunately, a reflection of the increasing cost of care," Kuderer said.
Most Washingtonians will never see this number. They get insurance through an employer, or Medicare, or Apple Health. The individual market is the leftover room of American coverage: about 250,000 people in our state who are self-employed, between jobs, working for small businesses, or retired too early for Medicare. It is a small room. It is also where the price of care shows up first, because no one else is absorbing it.
An average hides the spread, and the spread is where my desk's question lives. Regence BlueShield's increase for its roughly 16,000 members is 6.7%. Kaiser's, for more than 40,000, is about 14.1%. Coordinated Care, with about 98,000 members, is going up more than 25%. Community Health Plan of Washington, with nearly 37,000 members, is going up 30.5%. Two neighbors with the same income can open very different envelopes in November depending on which plan they happened to pick.
None of this is unique to Washington. Nationally, KFF's review of 276 insurers' filings found a median proposed increase of 15% for 2027, the second-highest request since 2018 and the second double-digit year in a row. The primary driver, KFF found, is the same one Kuderer named: health care itself keeps getting more expensive. But the individual market has a second problem stacked on top of the first.
At the end of 2025, the enhanced federal premium tax credits expired. Those subsidies had made marketplace plans cheaper for millions of people, and when they ended, the bills changed overnight. KFF found that enrollees faced an average 114% increase in what they paid to keep the same plan. Many didn't keep it. Those who stayed often traded down to cheaper plans with higher deductibles; even after switching, their net premium payments rose 58%, and their deductibles rose 37%, more than $1,000 a person. National enrollment fell from 22.1 million in 2025 to 19.2 million this February.
Here, the drop was about 36,500 people, nearly 13%, the largest decline since Washington's exchange opened in 2013. That is painful, but it is smaller than Ohio's or Oklahoma's, which each lost more than 32%. Washington runs its own exchange and its own state subsidy, Cascade Care Savings, which reporting credits with softening the losses. KFF found that all nine states with state-funded subsidies saw smaller drops than the national average. New Mexico, the only state that fully replaced the expired federal credits, was the only state where enrollment grew.
That last finding is the closest thing this story has to a controlled experiment. The people did not change; the price did. Where the price stayed within reach, people stayed insured.
And this is why a rate filing belongs on a health page and not just a business page. The people who drop coverage do not stop getting sick. They delay the checkup, skip the refill, and show up later, sicker, in an emergency room that has to treat them anyway. And the market feeds on itself: when prices rise, the people most willing to walk away tend to be the ones who expect to need the least care, which leaves a sicker pool behind. KFF lists that sicker pool, tied to the lost subsidies, among the drivers of next year's increases.
Open enrollment runs November 1 to January 15. "Families shouldn't experience sticker shock every year when shopping for health insurance," Kuderer said. They will this year. The question worth watching is how many decide, for the second November running, that the answer to the envelope is no.
