Southwest Washington leads state in premiums for qualified health plans and Medicaid

The average gross premium for qualified health plan coverage and Medicaid in Washington’s 3rd Congressional District is the highest in the state, according to a new report from the Washington Health Benefit Exchange.

This year, the average gross premium in the district was $820, compared to $700 in 2025. The 3rd District includes Lewis, Pacific, Wahkiakum, Cowlitz, Clark and Skamania counties. Other congressional districts in the state saw significant increases to their average gross premium, but none as high.

The number of Clark County residents who either selected or reenrolled in a qualified health plan decreased, mirroring statewide trends. Qualified health plans are available on Washington Healthplanfinder to state residents who are not covered by other means, such as through an employer, family member or federal program.

This spring, 18,547 Clark County residents enrolled in a qualified health plan compared to last spring’s 20,887 — an 11 percent decrease, according to data from the benefit exchange.

Between the end of open enrollment in mid-January and the end of March, approximately 14 percent fewer Washington residents were enrolled than the number initially reported by the exchange in the fall.

The organization originally projected more than 290,000 Washingtonians either selecting or automatically reenrolling in a qualified health plan during open enrollment. The final number, 250,000, is significantly lower because many customers will passively cancel by not paying their first or second monthly premium, according to the exchange.

Still, the exchange noted its projections are historically only 7 percent to 10 percent lower than reported in the preview report, compared to this year’s 14 percent decrease.

Washington Health Benefit Exchange Chief of Communications Tara Lee said in a news release that federal policy changes have created a healthcare affordability crisis in the state.

In November, Democrats and Republicans in Congress agreed on a spending bill that ended a 43-day federal government shutdown but didn’t reach a deal to extend expiring federal tax credits that offset the cost of premiums on some Affordable Care Act plans — the main point of contention for Democrats.

Both parties still have not been able to make an agreement on extending the tax credits, and the loss of those is compounded by further cuts and changes to the Affordable Care Act from President Donald Trump’s “One Big Beautiful Bill Act,” also known as H.R. 1.

A total of 5,710 Clark County residents lost their federal tax credits in 2026, according to the new report from the exchange.

The state’s mitigation efforts, including premium alignment and the Washington premium assistance program Cascade Care Savings, helped reduce the impact of federal changes, particularly for federally subsidized residents with incomes at 100 percent to 400 percent of the federal poverty level, Lee said.

“We know our state mitigation efforts have made a difference, and the coverage losses could have been greater,” Lee said. “However, we anticipate that ongoing federal changes and mandates will continue to impact affordability and access. The Exchange is committed to our mission of radically improving how Washingtonians secure health insurance through innovative and practical solutions.”

The Washington Health Benefit Exchange noted that during open enrollment, brokers, navigators and customer support center representatives were instrumental in clarifying savings, tax credits and policy changes. The exchange’s network of statewide assistants helped approximately 49 percent of qualified health plan enrollees select their 2026 health insurance.