New data from the state Medicaid exchange shows about 40,000 fewer Washingtonians are enrolled when compared with the same time last year.
OLYMPIA, Wash. — A Washington state coalition’s push toward a universal health care system is expected to continue into the next legislative cycle, even as current coverage through the Washington Health Benefit Exchange — which provides access to Medicaid, also known as Apple Health — faces mounting enrollment and affordability challenges.
Advocates and lawmakers are now looking ahead to the 2027 session after a key proposal, Senate Bill 5947, stalled in Olympia this year. The bill, described as a “trigger” for a universal system, would have laid the groundwork for a state-run plan providing comprehensive coverage to all residents.
While the measure did not advance out of the House before a key deadline, supporters say progress made over the past two years positions the effort for a stronger return.
A 2025 federal law allows states to pursue waivers to consolidate funding from programs such as Medicaid and Medicare into a unified, state-administered system, provided coverage meets federal standards.
Enrollment drops as costs rise
At the same time, Washington’s existing coverage system is showing signs of strain.
New data from the exchange’s upcoming spring 2026 report shows about 40,000 fewer Washingtonians are enrolled when compared with the same time last year, officials said.
Roughly one in four Washington residents currently receive coverage through Washington Healthplanfinder.
Officials attribute the decline largely to the expiration of enhanced premium tax credits and other federal policy changes affecting affordability. The exchange previously estimated that the costs associated with the expiration would be almost $1,000 per month — for a married couple in King County earning $120,000 annually, for example.
“Those who do remain enrolled on the exchange continue to face an affordability crisis,” said Laura Kate Zaichkin, the exchange’s director of market competition and affordability.
About 50,000 fewer Washingtonians are receiving tax credits this year. The exchange estimates roughly $275 million in enhanced federal subsidies will be lost.
Even with mitigation efforts from state partners, officials warn enrollment could drop by as much as 30% over the next several years, with many of those individuals potentially becoming uninsured.
Federal changes to Medicaid recently signed by President Trump will further disrupt coverage in 2027, including new work requirements, stricter eligibility for tax credits and the elimination of automatic renewals during open enrollment.
The nonpartisan Congressional Budget Office forecasts Medicaid spending will be reduced by $911 billion through 2034 and leave 10 million more Americans uninsured over that time frame.
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