Washington state has one of the most robust health coverage systems in the country. Whether you earn too little for marketplace subsidies or too much for Medicaid, there is likely a coverage option available to you through Washington Healthplanfinder. This guide explains who qualifies for ACA health insurance in Washington in 2026, what income limits apply, how subsidies work after key federal changes, and exactly how to apply.
What Changed for Washington ACA Coverage in 2026
The biggest shift for 2026 is the expiration of enhanced federal premium tax credits that were in place from 2021 through 2025. Those boosted subsidies made marketplace coverage more affordable for a wider range of incomes. Now that they have expired, the original "subsidy cliff" has returned, meaning federal premium tax credits are only available to households earning between 100% and 400% of the federal poverty level (FPL).
For Washington residents, this means some people who qualified for subsidies in 2025 no longer do at the federal level. However, Washington has taken steps to cushion the blow. The state's Cascade Care Savings program continues to provide additional state-funded subsidies for eligible enrollees, and Washington has adopted silver loading (a 43% load on Silver plan premiums), which increases the size of subsidy amounts and makes Gold plans more affordable for many people.
Washington ACA Eligibility Requirements
To enroll in a health plan through Washington Healthplanfinder, you must:
- Live in Washington state
- Not be enrolled in Medicare
- Not currently be incarcerated
Washington has also received federal approval (effective through at least 2028) to allow undocumented immigrants to enroll through the exchange and access state-funded Cascade Care Savings if their income does not exceed 250% of FPL.
To qualify for financial assistance (either federal premium tax credits or state Cascade Care Savings), you must also:
- Not have access to affordable employer-sponsored coverage
- Not be eligible for Medicare or Medicaid (Apple Health)
- Meet income requirements based on your household size
Income Limits: Who Qualifies for What in Washington
Washington's coverage landscape is organized around a few key income thresholds. Here is a breakdown for 2026, based on the 2026 federal poverty guidelines effective January 14, 2026.
Apple Health (Washington Medicaid)
If your income falls at or below 138% of FPL, you likely qualify for Apple Health, Washington's Medicaid program, which provides free or very low-cost coverage.
| Household Size | 100% FPL (Annual) | 138% FPL (Annual) |
|---|---|---|
| 1 person | $15,960 | $22,025 |
| 2 people | $21,640 | $29,863 |
| 3 people | $27,320 | $37,702 |
| 4 people | $33,000 | $45,540 |
| 5 people | $38,680 | $53,378 |
| 6 people | $44,360 | $61,217 |
Children have higher income limits for Apple Health: up to 215% FPL for children ages 0 to 18, and up to 210% FPL for pregnant women.
ACA Marketplace with Federal Premium Tax Credits
If your income is between 100% and 400% of FPL, you may qualify for federal Advance Premium Tax Credits (APTCs) that reduce your monthly premiums.
| Household Size | 100% FPL (Annual) | 250% FPL (Annual) | 400% FPL (Annual) |
|---|---|---|---|
| 1 person | $15,960 | $39,900 | $63,840 |
| 2 people | $21,640 | $54,100 | $86,560 |
| 3 people | $27,320 | $68,300 | $109,280 |
| 4 people | $33,000 | $82,500 | $132,000 |
| 5 people | $38,680 | $96,700 | $154,720 |
| 6 people | $44,360 | $111,000 | $177,440 |
Note: If your income is above 400% FPL, federal subsidies are not available for 2026 coverage. This is a change from 2021 through 2025, when the income cap was removed under the enhanced subsidy rules.
Cascade Care Savings (State Subsidy)
Washington provides an additional state-funded subsidy called Cascade Care Savings. For 2026, this benefit is worth approximately $55 per member per month for most enrollees with household income up to 250% of FPL. This subsidy is smaller than in prior years, but Washington's silver loading policy helps offset that by increasing the underlying premium tax credit amounts.
Cascade Care Savings is available to Washington residents who qualify for a marketplace plan, including undocumented immigrants who are enrolled through Washington's special federal waiver.
Plan Types Available Through Washington Healthplanfinder
Washington Healthplanfinder offers plans from 12 private insurers for 2026, up from 11 in 2025. Plans are organized into metal tiers based on how costs are shared between you and your insurer:
- Bronze: Lower monthly premium, higher out-of-pocket costs when you use care
- Silver: Mid-range premiums; used as the benchmark for calculating subsidy amounts. Those with income below 250% FPL may qualify for cost-sharing reductions (CSR) that lower deductibles and copays when enrolled in a Silver plan
- Gold: Higher monthly premium, lower out-of-pocket costs
- Platinum: Highest monthly premium, lowest out-of-pocket costs
Washington's silver loading policy makes Gold plans relatively competitive in pricing for 2026, especially for those receiving federal premium tax credits.
Cascade Care Plans
Washington offers two types of Cascade Care plans:
- Cascade Select (Public Option): State-contracted plans with negotiated lower rates. These became available statewide in 2025 and continue in 2026. They are often among the more affordable options on the exchange.
- Cascade Plans: Standardized plan designs that make it easier to compare benefits across insurers.
Both plan types are available through Washington Healthplanfinder alongside standard private insurance options.
When Can You Enroll?
Washington Healthplanfinder's open enrollment for 2026 coverage ran from November 1, 2025 through January 15, 2026. If you missed open enrollment, you can only enroll in a marketplace plan if you qualify for a Special Enrollment Period (SEP).
Qualifying Life Events for Special Enrollment
Common qualifying events include:
- Losing health coverage (job loss, end of Medicaid eligibility, aging off a parent's plan)
- Getting married or divorced
- Having or adopting a child
- Moving to a new coverage area
- Gaining citizenship or legal immigration status
- Certain income changes
Washington also has a Low-Income Special Enrollment Period that continues into 2026 for people with income at or below 250% FPL who are not enrolled in a Silver or Gold Cascade Care plan.
If you experience a qualifying life event, you typically have 60 days to enroll in a new plan. Apple Health (Medicaid) has no enrollment period, meaning you can apply and be approved any time of year if you are eligible.
Step-by-Step: How to Apply for ACA Coverage in Washington
Option 1: Online Through Washington Healthplanfinder
- Go to wahealthplanfinder.org
- Create an account or log in if you have an existing account
- Start a new application and enter your household information (household size, income, ages of family members)
- The system will determine whether you qualify for Apple Health, premium tax credits, Cascade Care Savings, or cost-sharing reductions
- If eligible for Apple Health, you can be enrolled automatically. If eligible for a marketplace plan, browse available plans and select one that fits your needs and budget
- Complete enrollment and pay your first premium if applicable
Option 2: By Phone
Call Washington Healthplanfinder's customer support at 1-855-923-4633 (TTY: 711). Representatives can walk you through the application process and answer eligibility questions.
Option 3: Get In-Person Help for Free
Free enrollment assistance is available through certified enrollment assisters and navigators across Washington. You can find local help through Washington Healthplanfinder or by contacting community health centers and hospitals in your area.
Option 4: Apply for Apple Health Separately
If you think you only qualify for Apple Health (Medicaid), you can also apply through Washington Connection or by calling 1-800-562-3022. Apple Health applications are processed within 45 days.
Not Sure What You Qualify For?
Washington Healthplanfinder is designed to screen you for all programs at once. When you apply, the system checks your eligibility for Apple Health, marketplace plans, and financial assistance simultaneously. You do not need to apply separately for each program.
You can also use our free benefits screener at BenefitsUSA.org to get a quick estimate of which programs you may qualify for before you apply. This can help you understand your options and prepare your application.
Cost-Sharing Reductions: Extra Savings on Silver Plans
If your income falls between 100% and 250% of FPL and you enroll in a Silver plan through Washington Healthplanfinder, you may automatically qualify for cost-sharing reductions. These reduce your deductible, copays, and out-of-pocket maximum, making care more affordable when you actually use it.
This benefit is in addition to the premium tax credit. It is only available on Silver plans, so make sure to compare the total value (monthly premium plus expected out-of-pocket costs) when choosing between plan tiers.
Apple Health: Washington's Medicaid Program
Apple Health is Washington's name for Medicaid, and it covers a large portion of the state's population. Key facts for 2026:
- Adults ages 19 to 64 qualify if household income is at or below 138% of FPL (approximately $22,025 for one person, $45,540 for a family of four)
- Children qualify at higher income levels, up to 215% FPL for most children
- Pregnant women qualify with income up to 210% FPL
- Coverage is free or very low cost with no monthly premium for most enrollees
- Apple Health covers doctor visits, hospital care, prescriptions, mental health services, dental for children, and more
- After-Pregnancy Coverage (APC) provides 12 months of postpartum coverage for eligible individuals
If your income increases during the year and you lose Apple Health eligibility, you can transition to a marketplace plan through a Special Enrollment Period.
Frequently Asked Questions
What if I earn too much for Medicaid but cannot afford marketplace premiums?
If your income is between 100% and 400% of FPL, you may qualify for federal premium tax credits that significantly reduce your monthly premium. Washington's Cascade Care Savings can provide additional savings if your income is at or below 250% of FPL. Use the Washington Healthplanfinder website or our free benefits screener to estimate your costs.
Can I get covered if I am self-employed?
Yes. Self-employed individuals are among the primary groups Washington Healthplanfinder is designed to serve. Your income for subsidy purposes is based on your projected net self-employment income for the year.
What if my income changes during the year?
Report income changes to Washington Healthplanfinder as soon as possible. If your income drops below 138% of FPL, you may qualify for Apple Health. If your income increases, your subsidy amount may decrease and you could owe money at tax time if you received more premium tax credit than you were entitled to.
Can I keep my current doctor?
Plan networks vary by insurer. Before selecting a plan, use the Washington Healthplanfinder comparison tool to check whether your preferred doctors and hospitals are in-network for plans you are considering.
What happened to the enhanced subsidies from 2021 through 2025?
The enhanced federal premium tax credits that eliminated the income cap for subsidies expired on January 1, 2026. For 2026 coverage, federal subsidies are once again limited to households with income between 100% and 400% of FPL. Washington's state-funded Cascade Care Savings remain available for income up to 250% of FPL.
Are undocumented immigrants eligible?
Washington has a federal waiver (effective through at least 2028) allowing undocumented residents to enroll in marketplace plans through Washington Healthplanfinder. They are not eligible for federal premium tax credits but can access state-funded Cascade Care Savings if their income is at or below 250% of FPL.
When is the next open enrollment period?
The next open enrollment for 2027 coverage will run from November 1, 2026 through January 15, 2027. If you need coverage now, check whether you qualify for a Special Enrollment Period or Apple Health, which is available year-round.
Key Contacts and Resources
| Resource | Contact | Website |
|---|---|---|
| Washington Healthplanfinder | 1-855-923-4633 | wahealthplanfinder.org |
| Apple Health (HCA) | 1-800-562-3022 | hca.wa.gov |
| Washington Connection (Benefits Portal) | 1-877-501-2233 | washingtonconnection.org |
| Find Local Enrollment Help | -- | wahealthplanfinder.org |
For a comprehensive overview of all benefits available to Washington residents, visit our Washington Benefits Overview page. You can also run a free eligibility check using our benefits screener to see all programs you may qualify for, from ACA coverage to SNAP, LIHEAP, and more.
