Question 1

Why are health insurance premiums rising 22% in Oregon and Washington for 2027?

Accepted Answer

When pandemic-era ACA subsidies expired in late 2025, average monthly net premiums for individual marketplace plans in Oregon and Washington rose by 58%. The youngest and healthiest consumers dropped coverage, leaving insurers with a high-utilization pool and catastrophic losses. As a result, remaining carriers hold immense pricing leverage, with Washington carriers requesting a 22.4% rate increase.

Question 2

What happened to Providence Health Plan?

Accepted Answer

Facing deep financial losses of more than $100 million in 2025, Providence announced it will transition out of most of its health insurance lines of business beginning in 2027, affecting roughly 400,000 Oregonians and Southwest Washington residents. Providence will not offer individual and family plans on the ACA exchanges for 2027, will not renew employer group plans as contracts come up for renegotiation, and did not file small-group rates for 2027.

Question 3

What happened to PacificSource and Moda Health?

Accepted Answer

PacificSource announced it will exit the ACA individual marketplace in Oregon, Idaho, Montana, and Washington after 2026, cutting 97 Oregon jobs. Moda Health announced it will exit the Oregon small group ACA medical market effective March 1, 2027 (final day of coverage February 28, 2027), while continuing to offer dental plans in the small group market. For individual ACA plans, Moda is pulling out of 8 Oregon counties (Marion, Polk, Deschutes, Klamath, Lake, Crook, Umatilla, and Union). Beginning in late Q1 2027, Moda will offer Equal Funding, a level-funded plan for Oregon small groups.

Question 4

Are Cigna and Aetna leaving the Oregon individual marketplace?

Accepted Answer

Yes. Cigna announced a total exit from the individual marketplace for 2027 to shield its bottom line, mirroring earlier pullbacks by Aetna. Both national giants are prioritizing highly profitable employer-sponsored group plans and corporate accounts over individual consumers.

Question 5

What is a 'ghost network' in health insurance?

Accepted Answer

A 'ghost network' occurs when a health insurance plan's directory lists doctors or hospitals that are no longer in-network or not accepting new patients. For 2027, patients will have to navigate a complex puzzle of whether their new insurance carrier has successfully negotiated a contract to include their trusted local doctors.

The Pacific Northwest Healthcare Landscape is Shifting

FEDERAL TRIGGER: Enhanced Premium Tax Credits Expire

MARKET SHIFT: Healthier Members Drop Coverage

FINANCIAL CRISIS: Sicker Risk Pool + Rising Care Costs

THE OUTCOME: Regional Exits, Consolidation, & Rate Hikes

Don't wait until open enrollment to find out your carrier left.

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