Dear Community,
As 2026 unfolds, it's essential to reflect on the adjustments to the Federal Poverty Level (FPL) and their far-reaching implications for our community, our patients, and our organization—Project Access Northwest. These changes signal not only a new set of numbers but also a significant shift in the operational realities for those we serve and the services we provide.
How are Federal Poverty Level Guidelines set?
The Federal Poverty Level (FPL) is determined annually by the U.S. Department of Health and Human Services (HHS). This measure is primarily based on the cost of living and the average expenses that families incur annually. The guidelines are updated each year to reflect inflation and other economic factors, allowing us to gauge the income thresholds at which families are deemed to be living in poverty or near-poverty. With an increase of approximately 2.6% for 2026, the 2026 FPL signifies crucial changes that affect many aspects of our service delivery and workforce.
Implications for our patients (at or below 300% FPL)
For the patients we serve, particularly those earning at or below 300% of the FPL, the changes make navigating healthcare more challenging:
- Expanded Eligibility for Programs: The new threshold of $47,880 for individuals (300% of $15,960) may seem positive, but the realities of healthcare access tell a different story, especially given the expiration of federal enhancements.
- Premium Increases: Patients enrolled in the Marketplace should brace for significant premium spikes, with many likely seeing their required contributions soar to 9.96% of their income. This increase can effectively double their out-of-pocket healthcare costs and may lead many to reconsider their insurance options.
- Demand for Assistance: As more individuals find themselves unable to afford Marketplace plans, we anticipate a surge in requests for our Premium Assistance program. The need for financial support is expected to grow, underscoring our role as a vital resource for our community.
Impact on our employees
As an employer, these shifts also shape how we deliver and value health benefits for our staff:
- Affordability Standards : The raised affordability threshold means our employer-sponsored health plans must remain accessible while accommodating rising employee wage expectations, reflecting the broader economic pressures on our workforce.
- Staffing Pressures : With living costs on the rise, particularly in the Puget Sound area, our team will feel increasing pressure to meet the health benefits expectations of our staff, many of whom may also be grappling with their financial realities in light of the latest FPL changes.
Our commitment as a nonprofit
At Project Access Northwest, our commitment to serving as a safety net for low-income residents is paramount. The 2026 FPL adjustments come with their own set of challenges:
- Coverage Gaps: The transition back to pre-pandemic Medicaid regulations and the impending “subsidy cliff” mean we should brace ourselves for increased demand from the "working poor"—those who fall into coverage gaps created by these changes but still need our specialized services.
- Navigator Funding Cuts: The drastic reduction in federal funding for insurance Navigators will place additional burdens on our care coordinators, as they will need to devote more time to assist patients with insurance complexities that would have previously been managed by these partners.
- Strategic Growth: Our 2024-2026 Strategic Plan is designed to address these systemic barriers head-on. The rising cost of living necessitates our expansion into new counties, ensuring that we can reach rural residents in Lewis, Mason, and Thurston, who will undoubtedly feel the strain of these economic pressures.
As we move forward, we remain steadfast in our commitment to adapt our programs and services to meet the evolving needs of our community. Together, we will navigate these changes and continue to advocate for accessible healthcare for all.
Thank you for your ongoing support and dedication to a healthier community.
With gratitude,
Gary Renville
President and CEO
Project Access Northwest