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.