Whatcom and Skagit County residents who shop for private health insurance on the state marketplace will see increased rates for 2025, along with decreased tax credits caused by the arrival of another insurance company to the area.
That’s the case for Bellingham business owner Jessie Polin, who will be paying nearly four times her current rate next year. Her Silver-level plan offered by insurer Lifewise has jumped in price from $47 per month for the past two years to $193 per month in 2025.
“I can say that as a small business owner in an expensive place to live, things like this just make it more difficult to maintain a sense of stability or plan for a sustainable future,” Polin said.
The health insurance marketplace, established through the Affordable Care Act (ACA) in 2013, is where people who don’t receive health insurance through their employers can compare plans and buy insurance, often at rates subsidized with tax credits from the federal and state governments.
As of September, 12,017 Whatcom County residents were enrolled in a marketplace plan and 45,724 were participating in Apple Health (Washington’s Medicaid program). In Skagit County, 4,797 residents had marketplace plans and 29,247 were on Apple Health.
Earlier this year, the state Office of the Insurance Commissioner (OIC) approved an average rate increase of 10.7% in 2025 for the 11 health insurers that sell in Washington’s marketplace.
“I know this rate increase will hit hard for many people, especially at a time when other expenses are up,” Insurance Commissioner Mike Kreidler said in a statement. “A key driver behind these rates is the increase in services used and the cost to deliver that care.”
ACA premium tax credits help lower the cost of health insurance. In 2024, 94% of enrollees in the U.S. qualified for tax credits. Normally when premiums increase, tax credits go up as well. But next year, not only will local marketplace customers see premiums increase, they’ll also see tax credits decrease.
The credits are calculated using a benchmark plan — the second-cheapest Silver level plan in the market — so when a new, lower-cost plan comes online in a county, it depresses the tax credit offered to all enrollees, even those who stay on their existing plan.
That has happened in Whatcom and Skagit due to the arrival of more-affordable Ambetter plans from Coordinated Care in 2025. Starting Jan. 1, Ambetter plans will be available in all 39 Washington counties, after Coordinated Care announced its expansion into Clark, Cowlitz, Island, San Juan, Skagit and Whatcom counties.
Whatcom County marketplace customers now can choose from four insurers: Coordinated Care, Lifewise, Kaiser and Regence Blueshield. Skagit customers have those options as well as BridgeSpan.
Coordinated Care, which had the largest share of plan holders on the Washington marketplace in 2024, was approved for a 9.3% average rate change by the OIC. Lifewise and Kaiser rates increased by 8% and 8.6% respectively, while BridgeSpan went up by 14.9% and Regence went up by 22.8%.
The local Ambetter provider network includes PeaceHealth, SeaMar and Unity Care NW, among others. Family Care Network, an independent primary health care group serving Whatcom and Skagit, is not currently in the Ambetter network.
“We look towards future opportunities to strengthen our partnership with [Family Care Network] while continuing our long-standing relationship in support of our Medicaid foster care members,” Coordinated Care Director of Communications Leanne Sangster wrote in an email to Cascadia Daily News. “We value our strong working relationship with FCN and remain committed to collaboration with all our providers to serve the community.”
But for those with specific health care needs, choosing the right plan at the right price can be challenging. Polin has been managing a chronic illness her whole life, and if she enrolled in an Ambetter plan, her gastroenterologist and therapist would not be covered by her new insurer.
“This is something that was totally avoidable and will have devastating consequences for a lot of people that live here who are absolutely going to lose their health care because they can’t afford it and the new plans are inadequate,” Polin said.
A CDN search of the Ambetter provider network on Dec. 12 yielded no rheumatologists in-network in Skagit or Whatcom County, and only one urgent care: North Cascade Urgent Care in Mount Vernon. In-network options for those services from Lifewise and Regence Blue Shield were more robust.
An OIC spokesperson said the office has received around 10 complaints this year from Ambetter plan holders across the state about not being able to find in-network providers.
The spokesperson wrote in an email to CDN: “It’s not uncommon for a developing network expanding its service area to cause some concern for consumers.”
When asked for comment, Coordinated Care responded, “We are proud to maintain full network adequacy, ensuring all members have access to appropriate services.”
Coordinated Care has been serving Washington since 2012. In 2017, Commissioner Kreidler fined the company $1.5 million for having an inadequate network of providers based on more than 140 complaints from enrollees. The insurer agreed in a consent order to fix its network deficiencies.
Marketplace open enrollment for coverage starting in February ends Jan. 15, 2025. Washington Healthplanfinder has a statewide network of brokers who can help enrollees find, compare and buy a plan for free. All plan rates are published online at insurance.wa.gov. There, customers can compare plans and tax credits specific to their location, income and demographic information.
Julia Tellman writes about civic issues and anything else that happens to cross her desk; contact her at juliatellman@cascadiadaily.com.
