Don’t Go Without Coverage: Understanding Health Insurance in Washington

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By Jordan Strobeck, Director,

Community Engagement and Growth, 

Community Health Plan of Washington

Uncertainty surrounding the federal Affordable Care Act (ACA) can make it feel overwhelming to make an informed decision about health insurance right now. 

The stakes are real: a recent poll from KFF suggests that 1 in 4 people who buy coverage through the ACA marketplaces would go without insurance next year if premiums (your regular or monthly payments) double—a possibility for some if Congress doesn’t act.

That’s not just a policy headline; it’s a human one. 

• It’s a person delaying a needed knee replacement because the deductible (what you pay up front) feels impossible. 
• It’s someone living with daily chronic pain when surgery would help, but “waiting it out” because the monthly cost (your premium) for insurance suddenly skyrocketed without federal help. 
• When coverage slips out of reach, people don’t stop needing care, they just stop seeking it. 

In moments like these, understanding what health insurance is and how it works becomes even more important. The basics can help you sort through the “noise,” know your options, and make choices that protect both your health and budget, regardless of what happens next at the federal level.

At its core, health insurance protects you from the financial burden of paying for medical care out of pocket. A single emergency room visit without insurance can easily cost $2,400. Insurance helps by sharing those costs with you. Instead of paying the full bill on your own, you pay a portion of it. Your insurance company then helps cover the remaining costs.

When you have health insurance coverage, many kinds of doctor visits are covered so you can receive regular checkups, screenings, and other preventive care that can catch health problems early, before they become serious or costly. 

And building a relationship with the same doctor means you’re able to get help managing your health in a consistent way. That kind of care is harder to receive without the benefit of insurance as many people who have to pay the full cost themselves delay seeing a doctor, or see whoever is on duty at an urgent care or emergency room.

In Washington state, there are several ways to access health insurance. 

• More than half of residents are covered through an employer, a spouse, or a domestic partner.
• Roughly 300,000 people, purchase plans directly from an insurance company or through Washington Healthplanfinder, the state’s online marketplace. 
• There are those who qualify for publicly funded health care coverage. 
• If you’re older or have certain health conditions, you may qualify for Medicare, which covers approximately 1.5 million Washington residents. 

If your income is lower, you may qualify for Apple Health (Medicaid), which serves nearly 2 million people statewide.

• Apple Health (Medicaid): Free or low-cost coverage if you meet income or eligibility rules, including low income, pregnancy/recent birth, under age 19, or living with a disability.
• Medicare: Coverage for people ages 65 and over, or under 65 years with a disability, or any age with end-stage renal disease; requires U.S. citizenship or 5 years or more of legal residency.
• Cascade Care (Healthplanfinder): Marketplace plans for those who don’t qualify for Apple Health, with free preventive care, more services covered before the deductible, and predictable costs. 
• Cascade Select remains available in 2026 for eligible incomes; federal savings depend on immigration status.

Most importantly, health insurance helps you stay healthy, connected to care, and avoid financial surprises. If you aren’t set up with coverage yet, act soon. 

While you can sign up for Medicaid year-round if you qualify, and Medicare if you have an available election period, Cascade Select enrollment through the marketplace is happening now through December 15, for coverage starting January 1. 

For marketplace plans, enroll by January 15 for coverage starting February 1.

Behind every enrollment deadline is a real person, someone who deserves care without risking their financial stability.