Idaho’s ACA Plan: Premium Increases Ahead
A public offering for an Affordable Care Act plan kicked off in Idaho on Wednesday, signaling to the rest of the nation what to expect for monthly premiums in 2026.
As enhanced subsidies that have kept some insurance costs manageable for many middle-class families come to an end this year, a lot of Idahoans will be faced with tough decisions about their insurance affordability.
Bob McMichael, 63, and his wife Leslie, 62, are already feeling the pinch. Both retired, they bring in about $42,000 annually and currently pay just $51 a month for their ACA plan. However, they recently received alarming news: their monthly premium is set to soar to $2,232 next year without the subsidy.
“We’re looking at sharp increases in health care costs, and continuity of care will likely be off the table come January 2026,” McMichael expressed.
In response to this notice, the McMichaels reached out to Sen. Mike Crapo (R-Idaho), urging him to support extending the subsidies.
This issue is at the heart of ongoing debates in Congress, as Democrats argue that Republicans should agree to renew enhanced subsidies introduced in 2021 before allowing a government reopening vote. State health officials warn that if the tax credit isn’t continued, the average out-of-pocket premiums in Idaho could jump by $1,200 annually, a staggering 75% increase.
“A significant number of people are going to see their premiums double, if not more,” said Hilary Matlock, policy director at Idaho Voices for Children, a nonprofit that supports access to health insurance.
This year, over 100,000 individuals in Idaho benefited from enhanced subsidies, and about 87% of the state’s ACA enrollees qualify for them, according to the data.
With the subsidy set to expire on December 31, approximately 25,000 Idahoans could lose their health insurance next year, according to Pat Kelly, executive director of Your Health Idaho, the state’s ACA marketplace. He noted that the state has been preparing for this potential loss and the anticipated premium hikes throughout the year.
“We dedicated a lot of time preparing our agents to communicate these changes to the public,” he mentioned.
Gideon Lukens, a senior fellow and director of research at the Center on Budget and Policy Priorities, a nonpartisan think tank, shared that a married couple aged 60 in Idaho with an income of $85,000 could see their monthly premiums rise by around $1,500. For a family of four earning $130,000, the increase could be about $650. “And that’s not an outlier,” he added. “For some, it could get even worse.”
“We’ve heard from multiple stakeholders that they’re trying to gather as many responses as possible before the end of the year,” Matlock noted, adding that there are concerns about how to handle the situation proactively due to these rising costs.
Lukens also mentioned that individuals enrolled in ACA plans who don’t qualify for tax credits are expected to face challenges too, predicting an average premium increase of about 18% as insurers adjust rates for the upcoming year. “It will effectively raise premiums for all marketplace participants in Idaho,” he explained.
Mark and Sarah Lathrop, who live in Coeur d’Alene, Idaho, aren’t eligible for the increased subsidies. Currently, they pay $1,116 monthly for their ACA plan, but they’ve been notified of a 21% increase to $1,351 next year, along with a rise in their out-of-pocket maximum from $12,000 to $18,400.
With business sales stagnating and costs climbing due to tariffs, Mark Lathrop shared that he’s already reduced travel and dining expenses. Despite the insurance hikes, they intend to keep their coverage due to ongoing medical needs.
“I don’t think my situation is as unfavorable as others losing tax credits, but I believe this resonates with many small business owners,” he reflected.
