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Washington Obamacare

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Washington 2023 Obamacare Rates

Learn about the 2023 rates for Obamacare in Washington.

What Washington State Residents Need to Know About Obamacare for 2023

In Washington, Affordable Care Act (Obamacare) open enrollment is over, but you may still qualify for 2023 coverage.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in Washington:

1. Washington open enrollment has ended, but you may be able to use a special enrollment period to get covered.

In Washington, open enrollment for 2023 Affordable Care Act (Obamacare) coverage has ended. This means that, unless you qualify for an exception or your income is low enough for Medicaid, you won't be able to get health insurance through Washington Healthplanfinder until open enrollment for 2024 begins next fall.

If you’ve lost your job or significant income in the past 60 days, you might qualify for a special enrollment period (SEP). A SEP allows you to sign up for a new health insurance plan or change your current one outside the open enrollment window.

In addition to job or income loss, many other qualifying events may make you eligible for a SEP. To learn more, see What Happens If I Missed the Washington Obamacare Enrollment Deadline?

2. You won’t face a tax penalty for going without health insurance in 2023—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)

 3. You may qualify for new Affordable Care Act subsidies.

In 2021, President Biden signed the American Rescue Plan Act (ARPA). The law provided $1.9 trillion of federal aid to Americans struggling with the COVID-19 crisis, including additional premium subsidies for those who purchase health insurance through Washington Healthplanfinder. In 2022, the Inflation Reduction Act extended these more generous subsidies through 2025. Here’s a quick summary of the types of available subsidies.

Federal tax credits. Under ARPA, no one will have to pay more than 8.5% of their household income for a mid-level plan purchased from Washington Healthplanfinder. Technically, the subsidies are tax credits, but you can choose to have them automatically deducted from the cost of your monthly premiums.

Cost-sharing subsidies. More than half of the people who purchase coverage through Washington Healthplanfinder receive assistance through cost-sharing reductions (CSRs). CSRs automatically reduce your premiums and lower your costs when you use your insurance benefits—for example, when you go to the doctor, get lab work, or have to stay in the hospital.

CSRs are available to people who make between 100% and 250% of the federal poverty level. (For 2023 health plans, that means a family of four in Washington can't earn more than $75,000 and an individual not more than $36,450.) But these benefits are available only on silver plans. If you think you may qualify, look carefully at the costs for silver plans available at Washington Healthplanfinder while shopping for coverage.

Medicaid. You may qualify for free or low-cost coverage through Apple Health in Washington if your income is very low.

All subsidies will be automatically calculated when you apply for a plan through Washington Healthplanfinder.

For more information, see Ways to Save Money on Obamacare in Washington.

3. Washington provides free health insurance for many child-care workers.

Washington state residents employed by licensed child-care facilities can obtain free health insurance coverage as long as:

  • their income doesn't exceed 300% of the federal poverty level (300% of the 2022 FPL is $40,770 for an individual and $83,250 for a family of four)
  • they're not eligible for Medicare or Medicaid
  • they enroll in a Cascade Care silver plan, and
  • they accept all federal subsidies that are available to them.

4. Washington offers a public option for health insurance in 20 counties.

In 2021, Washington became the first state to offer a public option for health insurance, called Cascade Care. Cascade Care is now available in every Washington county.

Washington's public option program looks different from what most people think of as a "public option" because the state doesn't provide the insurance. Instead, the state controls the terms and manages the costs, while private insurance companies deliver the plans themselves.

Cascade Care plans come with their own subsidies, available to Washington residents making up to 250% of the federal poverty level. In 2022, that's $36,450 for an individual and $75,000 for a family of four.

5. Average premium rates are going up, but that doesn't mean you'll pay more.

Nationwide, the average rate increase for 2023 health plans was about 7.7%. In Washington, the average number is higher, coming in at an increase of 8.2%. But remember that this number doesn't tell you how much you'll pay for health insurance. Costs vary from insurer to insurer and plan to plan. Also, if premiums for the benchmark plan (the plan used to determine subsidy amounts) go up, subsidies will go up, too. This is a long way of saying don't let the numbers get you down. Comparison shop at Washington Healthplanfinder to find the plans and subsidies available to you.

6. You won’t face a tax penalty for going without health insurance in 2023—but there are big downsides to being uninsured.

Obamacare’s tax penalty went away in 2019. That means that if you don’t have health insurance, you won’t have to pay a penalty when you file your federal income taxes. That said, think about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than the penalty. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.)

7.  Insurers don't sell short-term insurance plans in Washington.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. Short-term plans don’t have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. In the past, short-term plans were allowed to last only three months but under new rules, you can purchase a non-ACA-compliant “short-term” plan that lasts as long as three years. In Washington, however, short-term health plans are still limited to three months and are not renewable. Currently, no insurer is offering short-term plans in the state.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Washington.

8. You can get help signing up if you need it.

The Biden administration has greatly increased enrollment assistance, making it much easier to get the information you need to get covered. To connect with local support resources, see How To Sign Up for Obamacare in Washington.

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How To Sign Up for Obamacare in Washington

For 2023 health plans, Washington open enrollment has ended. However, you may still be able to purchase health insurance for this year if you qualify for a special enrollment period. For example, if you’ve recently lost your job or significant income, you might qualify for a 60-day special enrollment period that will allow you to sign up for a new health insurance plan. (See What Happens If I Missed the Enrollment Deadline?)

To get covered, you can go directly to the online health insurance marketplace for Washington. If you need personalized help, you can reach out to an enrollment assistant. Most enrollment helpers are working remotely during the COVID crisis.

Where's the Washington Health Care Exchange?

You can find the health insurance exchange for Washington at Washington Healthplanfinder. This is where you can learn about the various health insurance options available to you under Obamacare. If you see a plan you like, you'll be guided through the enrollment process online. 

Getting Personalized Help with Enrollment

In Washington, if you need help understanding your options for coverage under Obamacare or signing up for a plan, you can get free help from an enrollment assistant or from a licensed health care agent or broker.

An enrollment assistant can explain your options, answer your questions, and help you apply for your chosen plan, but they can’t legally recommend a specific one for you.

To find a Washington certified assistant, see Get Help Enrolling at Washington Healthplanfinder. You can then search for a helper in your area.

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How Much Does Obamacare Insurance Cost in Washington?

This article explains the costs of health care plans offered under the Affordable Care Act (commonly called Obamacare) for individuals or families who are currently uninsured or not covered by a job-based health plan.

What you'll pay for an Obamacare plan depends on five things:

  1. The level of coverage you choose
  2. Whether you qualify for a subsidy
  3. Where you live in Washington
  4. Your age
  5. Whether you smoke

Read on to learn more about each of these factors.

1. The Level of Coverage You Choose

Obamacare insurance plans offer four levels of coverage:

Platinum -- covers approximately 90% of health care costs
Gold -- covers approximately 80% of health care costs
Silver -- covers approximately 70% of health care costs
Bronze –- covers approximately 60% of health care costs

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Washington Medicaid Expansion: Do I Qualify for Medicaid Under the ACA?

The Affordable Care Act (Obamacare) expanded Medicaid eligibility to include more people who couldn’t otherwise obtain health insurance. As written, the ACA would extend Medicaid to all adults with incomes at or below 138% of the federal poverty level. (For a single person in Washington in 2021, that’s $20,120. For a family of four, it’s $41,400.)

However, the U.S. Supreme Court later ruled that it was up to individual states to decide whether to expand Medicaid. As of October 2021, 12 states have not expanded their programs.

Washington Has Expanded Medicaid

Because Washington did decide to expand its Medicaid program, residents can qualify for Medicaid more easily today than in years past.

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How Much Is the Obamacare Tax Penalty in Washington for 2023?

There's No Federal Tax Penalty for Being Uninsured

Legally, the Affordable Care Act -- aka Obamacare -- still says that you must have health insurance. Practically speaking, however, the tax penalty for being uninsured has dropped to zero. That means you'll still have to report your coverage status on your federal tax return, but you won't have to pay a penalty if you aren't covered.

A handful of states have passed health insurance requirements to replace the federal mandate. As we approach open enrollment for 2023 health plans, those states are California, the District of Columbia, Massachusetts, New Jersey, and Rhode Island. Vermont also passed a law, but never established an active penalty to go along with it.

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Understanding Obamacare's Preventive Health Care Benefits

Get vaccinations, mammograms, colonoscopies, and other essential services for free

The Affordable Care Act requires health insurance plans to offer certain preventive care services free of charge -- or more accurately, for nothing more than the cost of your monthly insurance premiums. This rule applies to most plans sold directly by insurance companies and all plans sold through the health care marketplace for Washington. Covered preventive services are available for free (meaning no co-pay or other out-of-pocket charges) whether or not you’ve met your plan’s annual deductible.

Tips for Using Your Preventive Care Benefits – And Avoiding Unexpected Charges

Below, you’ll find a list of free preventive benefits -- screening tests, counseling services, and vaccinations -- for adults, women, and kids. But first, here are some pointers to help you avoid an unexpected bill for services you thought were preventive.

Use a network provider. To get a preventive service for free, you must use a health care provider in your insurance plan’s network.

Know the difference between “preventive” and “diagnostic.” Doctors can use screening tests for either preventive or diagnostic reasons. For example, having a routine mammogram every year or two is preventive care for women over 40. But if you schedule a mammogram because you feel a lump or have breast pain, that’s diagnostic. Likewise, a routine colonoscopy is recommended for adults over 50, but if your doctor schedules a colonoscopy to investigate a problem like blood in your stool, it becomes a diagnostic procedure. Preventative services are free; diagnostic procedures are not. (If the timing is right -- say, you go to the doctor because you find a lump in your breast but you also happen to be due for an annual mammogram -- your doctor may bill the diagnostic procedure as preventive, but that’s not something you can count on.)

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Get Help Finding a Health Insurance Plan in Washington

Get Help From Washington's Health Insurance Exchange

The following links and telephone numbers take you to the official help resources for Washington Healthplanfinder, the health insurance marketplace for Washington.

Get help by phone: 855-923-4633

Get help in person: To find a certified navigator, you can use the Navigator Search page at Washington Healthplanfinder. 

Get Help From a Licensed Insurance Broker

To directly connect with a Washington insurance broker who can help you evaluate insurance plans and choose a plan that's appropriate for your situation, call 800-943-6832. (We receive advertising income from the licensed brokers who offer their services through this telephone number.)

More Information

For more detailed information, see How Do I Sign Up for Obamacare in Washington?



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Obamacare for Self-Employed Washington Residents

Many self-employed people will be quick to tell you that getting and paying for health insurance is one of the biggest challenges they face. For some, however, the Affordable Care Act (Obamacare) may make things easier by providing new coverage options for the self-employed.

Are You Self-Employed or an Employer? 

Before you start evaluating your options for health coverage, you need understand whether the Affordable Care Act thinks you're self-employed.

The ACA says you are self-employed if you are an independent contractor or a sole proprietor without employees. (If you hire other independent contractors to do some work for you, you probably still qualify as self-employed.) If you are self-employed, you can use Washington Healthplanfinder to compare health insurance plans and sign up for the one that works best for you.

If you have employees – usually, workers whose income you report on a W-2 at the end of the year -- you’re considered an employer. In that case, you can learn about purchasing health insurance for yourself and your employees through the SHOP Marketplace. You will be connected with a registered SHOP (Small Business Health Options) agent or broker who can help you understand your coverage options.

If you aren’t sure whether the people who work for you are independent contractors or employees, read "Independent Contractor (Self-Employed) or Employee?" on the IRS website.

What the Affordable Care Act (Obamacare) Means for Self-Employed People in Washington

Here are seven things self-employed people should know about the Affordable Care Act:

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What Domestic Partners Need to Know About Applying for Health Insurance Under Obamacare

When registered domestic partners or civil union partners apply for coverage at an Affordable Care Act health insurance marketplace, there’s one question that almost always arises: Do we apply based on our separate incomes or must we include all the income we make as a couple?

The answer depends on the state where you live.

States other than California, Nevada, or Washington. In almost all states, registered domestic partners or civil union partners who apply for insurance via the state’s health insurance exchange must do so separately. Each partner includes only his or her separate income, and this amount determines health plan costs and eligibility for cost-saving subsidies. It works this way because domestic partners are not considered married for federal tax purposes. (If you registered first and got legally married later, this article doesn't apply to you. You must apply as a married person and report your combined income.)

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Washington Obamacare Scams: What They Are, How to Avoid Them & Where to Report Them

If someone calls you on the phone in Washington offering you discount health insurance for $29 a month, hang up and report them to the Washington State Office of the Insurance Commissioner

Worthless insurance is one of many scams that unscrupulous people are trying to sell to consumers confused by Obamacare. To satisfy the requirements of the new law, you must have a qualified insurance plan. If you don't, not only will you miss out on cost-saving insurance subsidies, you will probably be subject to a tax penalty.

Beware of scammers who may try to persuade to you buy insurance outside of Washington Healthplanfinder. Below is a list of common types of scams.

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Obamacare and Seniors

If you’re over the age of 65, your health insurance options under the Affordable Care Act (Obamacare) depend on whether or not you’re covered by Medicare or another insurance plan. To find out what, if anything, you need to do, find the situation below that applies to you.

You have Medicare. If you’re already enrolled in Medicare, you’re considered covered under the ACA, and you don’t have to do anything. In fact, it’s illegal for someone who knows you have Medicare to try to sell you a plan through an ACA health insurance marketplace.

The Affordable Care Act does enhance your existing Medicare coverage by providing additional preventive care benefits, such as cancer screenings and an annual wellness visit.

For more information on Medicare coverage, go to Medicare.gov.

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Can I Use a Paper Application to Get Obamacare?

When Obamacare first launched, the federal and state health insurance marketplaces (also called “exchanges”) were plagued by technical troubles. Many people who tried to sign up for new health insurance plans online in the early days were unable to complete their applications.

Because of these difficulties, some individuals and application assistants turned to the old-school way of getting health insurance -- paper applications.

Applying on Paper May Not Be Better or Faster

When facing a slow or broken online health insurance exchange, using a paper application may seem tempting -- at least it would provide the feeling of getting something done. However, paper forms may not speed up the process at all. On the contrary, they could slow down your application even more.

The worker who reviews your paper application must manually enter the information from your forms into the same system you would use online at your state’s exchange. It won’t work any faster for them than it does for you. Plus, using a paper application opens up more opportunity for error by putting more people between you and your goal of getting insurance.

It’s still best to apply online if you can. That said, if you feel that you’re unlikely to come back and apply for health insurance later, you may want to go ahead and complete a paper application now. 

To get a paper application, call the Washington Healthplanfinder customer service center and let them know you want to apply on paper. They'll point you to a downloadable application or send you one in the mail. For detailed Washington Healthplanfinder contact information, see How To Sign Up for Obamacare in Washington.



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When Are You Legally Required to Report “Life Changes” to the Washington Health Insurance Exchange?

Are you planning to get married, change jobs, or move to a new state? If so, you might have to share your big news with Washington Healthplanfinder.

Which Changes Must You Report? 

If you buy a health insurance plan through the Washington marketplace, the Affordable Care Act requires you to report changes that may affect your insurance coverage. These changes include: 

  • moving to a new state or insurance coverage area
  • significant changes in income
  • getting new health coverage through a job
  • signing up for Medicare or Medicaid
  • getting married or divorced
  • becoming pregnant, having a child, adopting a child, or placing a child for adoption
  • losing or gaining a dependent
  • becoming disabled, and
  • other changes that affect your income or household size.

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About This Website

We built this website to get people the answers they need about the Affordable Care Act (Obamacare). Our goal is to guide you to reliable, local information about your new health insurance options.

When you choose your state or enter your zip code here, you will quickly learn:

  • whether or not you're required to get health insurance

  • what the available plans cover

  • how much coverage will cost, and

  • how to sign up in your state.

For those concerned about cost, we show you how to determine whether you qualify for subsidies.

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