Idaho began open enrollment Wednesday for Affordable Care Act plans offering preview of the rest of the country about how much monthly premiums will increase in 2026.
Many Idahoans will have to decide if they can afford insurance after expanded subsidies that reduced insurance premiums for many middle-class families, the expiration date is at the end of the year.
Bob McMichael, 63, and his wife Leslie, 62, already know that won't happen.
Both are retired and earn about $42,000 a year. They currently pay $51 per month for their ACA plan. Late last month they received notice that their monthly bonus without subsidies will increase to $2,232 next year.
“We are facing incredible growth in health care volume, and we will likely not be able to continue receiving care as of January 2026,” McMichael said.
After receiving the notice, the McMichaels wrote a letter to Sen. Mike Crapo, R-Idaho, urging him to support extending the subsidies.
This is the solution at the center of the government shutdown fight on Capitol Hill, where Democrats say Republicans must agree to maintain increased subsidiesfirst introduced in 2021 before they vote on whether to reopen the government. Without the tax break, average insurance premiums in Idaho would rise by $1,200 a year, an increase of 75%, according to state health officials.
“Quite a large number of people will see their premiums double, if not more,” said Hillary Matlock, policy director for Idaho Voices for Children, a nonprofit group that advocates for access to health insurance.
More than 100,000 people in Idaho received expanded subsidies this year — about 87% of all ACA enrollees in the state, according to the ACA. Centers for Medicare and Medicaid Services.
About 25,000 Idahoans would likely drop coverage next year if subsidies expire Dec. 31, said Pat Kelly, executive director of Your Health Idaho, the state's ACA marketplace.
The state has spent the past year preparing for the elimination of subsidies and expected premium increases, Kelly said.
“We spent the majority of our time this year training agents on what the changes will be and how we will communicate those changes to their consumers,” he said.
Gideon Lukens, senior fellow and director of research and data analysis for the health policy group at the Center on Budget and Policy Priorities, a nonpartisan research group, said a 60-year-old couple earning $85,000 a year in Idaho could see their monthly premiums increase by about $1,500.
A family of four making $130,000 a year could see their monthly premiums increase by about $650. “And this is no exception,” he said. “It's going to be a lot worse for some people.”
“We've heard from several people that they're trying to get as much care as possible before the end of the calendar year just because they're concerned about not being able to address issues preventatively or even get appointments next year because of the cost,” said Matlock with Voices for Children of Idaho.
People on ACA plans who aren't eligible for tax breaks also won't be spared, Lukens said: Premiums growth is expected to average approximately 18%. Insurers are raising rates for them next year.
“Virtually everyone in the market in Idaho will see an increase in insurance premiums,” he said.
Mark and Sarah Lathrop of Coeur d'Alene, Idaho, do not qualify for the increased subsidies. The couple who own Liberty Lake Bodegas just across the border in Washington currently pays $1,116 a month for their ACA plan.
The 2026 renewal notice shows premiums will rise to $1,351 per month, a 21% increase, and the plan's out-of-pocket maximum will jump from $12,000 to $18,400.
Mark Lathrop said they had already cut back on travel, food and other expenses as sales in their wine business fell and costs rose, largely due to tariffs.
Despite the higher premiums, the couple plans to maintain insurance due to a health condition that requires annual monitoring.
“While I don't think my situation is as bad as some others who are losing tax benefits, it will be a common occurrence among small business owners,” Mark Lathrop said.
