By Aaron Allen, The Seattle Medium
King County residents shopping for health insurance in 2027 face higher premiums and new federal eligibility rules, but free assistance is available to help families compare plans, maintain coverage and understand changes to Washington Apple Health.
Open enrollment through Washington Healthplanfinder began Nov. 1 and continues through Jan. 15, 2027. Residents who enroll by Dec. 31 can obtain coverage beginning Jan. 1, while those enrolling in January can begin coverage Feb. 1.
The enrollment period comes as individual health insurance premiums rise and federal changes affect financial assistance, Medicaid eligibility and coverage options for some immigrants.
Daphne Pie, regional health services administrator for Community Health Services at Public Health Seattle & King County, oversees the county’s Access and Outreach team and its network of health insurance navigators. She said the enrollment period gives uninsured residents an opportunity to obtain coverage and allows current policyholders to reconsider their options.
“Health insurance open enrollment is that time of the year where individuals who don’t have insurance can look at their healthcare options,” explained Pie. “If someone’s currently enrolled in the qualified health plan, it’s the time of the year where they can go shopping, where they can look at other plan options, they can look at other insurance plans… they can look at their coverage options.”
The annual enrollment window applies primarily to individual and family health plans purchased through Washington Healthplanfinder. Residents eligible for Washington Apple Health, the state’s Medicaid program, can generally apply throughout the year. Certain life events, such as losing other coverage, may also allow residents to enroll in private insurance outside the annual window.
For 2027, Washington regulators approved an average premium increase of 22.2% for plans sold through the state’s health insurance exchange. Actual increases vary by insurer and plan, making it important for residents to review renewal notices rather than automatically keep their existing coverage.
“Most people may have heard that the insurance premiums have gone up, on an average about 20% and that is true. Some of the insurance premiums have increased, and what we want individuals to do is really shop for the best coverage for themselves,” noted Pie. “So, if someone’s already on, they already have a qualified health plan, they’ve probably already gotten a letter, and in that letter it’s indicating what their new cost is going to be for 2027.”
When comparing plans, residents should consider more than the monthly premium. Deductibles, copays, prescription costs and annual out-of-pocket limits can significantly affect what a family pays for care, particularly when someone needs regular treatment or medication.
Pie recommends starting with the doctors and medical facilities a person already uses, then checking whether those providers and any necessary prescriptions are covered by the plans under consideration.
“We always tell people, start with where you go to the doctor, making sure it’s continuity of care,” said Pie. “If there’s certain medications that you check, that you take, search by your medications, because what it’s going to do, the health plan finder is pretty savvy. So, it’s going to bring you out all the health plans once you enter all your health, with your medication, about which plan is going to pay for your medication.”
For residents who depend on Apple Health, the changes extend beyond rising insurance costs. New federal requirements beginning Jan. 1, 2027, could affect whether certain adults remain eligible for Medicaid coverage.
Under federal legislation known as H.R. 1, the requirements generally apply to adults ages 19 to 64 enrolled through the Medicaid expansion program. Those affected may satisfy the rules by earning at least $580 a month, completing 80 hours of qualifying activities monthly or meeting an exemption.
Qualifying activities include employment, education, job training, volunteer work and certain combinations of those activities.
Not every Apple Health recipient is subject to the new requirements. Exclusions and exemptions include certain parents and caregivers of children under 14 or people with disabilities, pregnant residents, qualifying people with physical or mental health conditions, American Indians and Alaska Natives, and current or former foster youth under 26.
People already meeting applicable work requirements through Basic Food assistance or Temporary Assistance for Needy Families may also qualify for an exclusion. Students participating in approved educational programs may be able to count their school activities toward the monthly requirement.
For 2027, residents may be able to self-attest that they meet certain exemptions, including qualifying health conditions, without immediately submitting formal documentation.
“The message for 2027 is someone can self-attest that they meet an exemption,” explained Pie. “Let’s say one of the questions is, do you have a physical or mental disability that prevents you from working? If the answer is yes, I do, you can self-attest. That means you don’t have to prove documentation for 2027. You can self-attest that you meet one of these exemptions for 2027.”
Residents are encouraged to keep their contact information current, review notices from Apple Health and maintain records of qualifying activities or circumstances that may affect their eligibility.
Some immigrant families face additional uncertainty as federal changes alter which noncitizens qualify for Apple Health and financial assistance to purchase private insurance.
Washington Apple Health eligibility changed for certain noncitizens beginning Oct. 1, 2026. Additional federal restrictions taking effect Jan. 1, 2027, will limit eligibility for premium tax credits, the federal subsidies that help people pay their monthly insurance premiums.
The effects vary by immigration classification and insurance program. Some lawfully present immigrants may remain eligible to purchase private coverage even if they no longer qualify for federal financial assistance.
“As of September 30th, individuals who were, who are here, they’re here lawfully, right? They could have been asylees; they could have been refugees. However, they don’t meet that new definition, and that new definition is lawfully present for 5 years,” noted Pie. “Those individuals not only lost their Apple health coverage, but they’re also going to lose the ability to buy a health plan and get premium assistance. Non-citizens who have not met that five-year requirement, they can still buy a qualified health plan, but they would not get that premium tax credit that’s going to help them pay their premiums.”
Because the eligibility rules differ, residents affected by the changes should consult a certified health insurance navigator before assuming they have lost access to coverage.
For residents who lose eligibility for federal assistance or struggle to afford available plans, King County offers services to help identify coverage options and, in some cases, reduce insurance costs.
Public Health Seattle & King County’s Access and Outreach program provides free, confidential assistance through trained navigators. The county’s Community Health Access Program, known as CHAP, helps residents understand eligibility, compare insurance plans and apply for available programs.
The county also has a local Premium Assistance Program, funded through the Department of Community and Human Services, for certain low-income residents who do not qualify for Apple Health or federal premium tax credits.
Under the program criteria provided by the county, applicants must live in King County, have gross monthly household income at or below 100% of the federal poverty level and enroll in an eligible Cascade Care plan.
The published monthly income limits are $1,304 for one person, $1,762 for two, $2,220 for three, $2,679 for four, $3,137 for five and $3,595 for six.
Program materials identify Ambetter, Community Health Plan of Washington and Molina as participating insurers. Cascade Care plans offer certain benefits before a deductible is met, potentially reducing upfront costs for residents who need medical services.
Because funding is limited and enrollment is handled on a first-come, first-served basis, meeting the eligibility criteria does not guarantee assistance. Residents should confirm current income limits, participating insurers and funding availability with a county navigator.
Navigators can also help families determine whether they qualify for other forms of assistance, including Washington’s Cascade Care Savings program, which can reduce monthly premiums for eligible residents.
Residents can explore available plans at wahealthplanfinder.org and find local enrollment assistance through King County’s Access and Outreach program at kingcounty.gov/en/dept/dph/health-safety/health-centers-programs-services/access-outreach-program.
For free, confidential assistance, residents can call the Community Health Access Program at 1-800-756-5437. In-person enrollment assistance is also available through community locations, including a Federal Way storefront at 1640 S. 318th Place. Residents should confirm hours before visiting.
Pie encouraged families who receive notices about rising premiums or changing eligibility not to assume they have exhausted their options.
“If you’ve got a letter in the mail and that letter indicated your premium has gone up, don’t lose hope,” said Pie. “Allow us to help you see if there’s a better option out there.”
