Brittany Rush’s Health Insurance Dilemma
Brittany Rush, a resident of Boise, was persuaded by her mother and sister, both in healthcare, to look into health insurance. To her surprise, when examining options on Idaho’s Affordable Care Act Marketplace, she found her premium costs to be quite low. She initially chose the mid-level Silver plan for just $4 a month in 2024 and then renewed it for under $33 in 2025.
However, to keep that plan in 2026, her monthly payments would exceed $400. This significant increase is due to Congress not extending the pandemic-era subsidies, which had made ACA plans more affordable for countless Americans. Many are likely to face unpleasant surprises when applications open on November 1st, as Congressional Democrats have stalled approval for a federal spending bill that would extend those aids, resulting in a prolonged federal government shutdown.
Residents in Idaho, like Rush, who began enrolling on October 15th, are already feeling the pinch of rising premiums. Rush, unable to manage over $400 in premiums, sought help from an insurance broker and found a plan for around $124 monthly. Even that feels too steep for her, as she balances her cleaning business with everyday expenses.
“So my plan right now is to be uninsured by the end of the year, and starting in 2026, I won’t be able to get health insurance,” the 38-year-old shared. She mentioned she would likely pay cash for doctor visits next year. Sadly, she’s not alone—many in Idaho are expected to drop their ACA coverage, with estimates predicting over 4 million nationwide could lose their insurance as subsidies vanish.
Idaho’s Premium Spike
When Idaho opened enrollment on October 15, the state experienced a surge in inquiries. Officials notified consumers through email and regular mail about the expected premium increases for next year, allowing changes to plans until December 15, 2026, before the new coverage begins on January 1, 2026.
In total, around 115,000 residents in Idaho are enrolled in ACA plans, while another 20,000 have dental insurance. Pat Kelly, the executive director of Your Health Idaho, indicated that around 25,000 Idahoans might cancel their health insurance due to the loss of federal aid, which would result in higher co-payments. Next year, they project an average price rise of about 10% for ACA plans, but without enhanced tax credits, that could mean a staggering 75% increase—around $100 more per month, according to Kelly.
Maria Rogers, an insurance broker, anticipated even steeper hikes in many other states. “It’s causing great anxiety across the country,” she stated, hinting at the broad impact of these changes.
If Congress fails to act, subsidies revert to pre-pandemic levels, which means costs will rise for many. Under the 2010 Affordable Care Act, subsidies were capped for those earning four times the federal poverty level. Although enhanced support was temporarily provided during the COVID-19 pandemic, with its conclusion in 2023, these benefits are set to end by the close of 2025.
Those earning above the qualifying income limits will now bear the full cost of their ACA plans. For instance, a family of four in Idaho with an income around $130,000 could face an annual premium increase of about $17,000 for a mid-level plan—certainly quite striking.
Since 2022, the state’s ACA enrollment has surged by 84%, largely thanks to the pandemic subsidies, which significantly reduced the uninsured rate in Idaho.
The Realities of Going Without Health Insurance
Kathy Newcombe, a retiree from McCall, Idaho, and her husband are also facing the loss of federal aid. Their income exceeds the poverty threshold, and they will lose a monthly tax credit of $656 that helped make insurance more affordable. Their monthly premium is set to rise significantly, adding to their financial worries.
Newcombe, 63, had reliable employer-sponsored health insurance until July but turned to ACA coverage until she qualifies for Medicare. Living without health insurance simply isn’t an option for her. As someone with type 1 diabetes, she relies on an insulin pump and other high-cost supplies. She estimated that her necessary expenses for her diabetes management total around $2,500 every three months, despite her insurance covering some of those costs.
“Your premiums could rise by 103%, but you’ll still need to spend a hefty amount just to keep your insulin pump therapy going,” she expressed, voicing concern for others who might struggle even more with these financial burdens.
Notably, around 2 million Americans with type 1 diabetes require medication to control their blood sugar, with millions more facing similar issues as type 2 diabetes progresses.
Those who cut back on medication due to cost could face dire health implications. Newcombe remarked, “I can say that Congress knows about it, but it doesn’t act on it every day.”
Future of ACA Subsidies
As millions grapple with rising premiums, the federal marketplace recently updated details about the ACA plans for 2026, revealing an average expected rise of 26%. Of the approximately 24 million currently enrolled, about 22 million rely on subsidies, making the loss of enhanced support especially troubling. KFF reported that average out-of-pocket expenses are projected to more than double as these benefits disappear.
General inflation is a hot topic, especially with the 2024 presidential election on the horizon. Advocacy leader Anthony Wright expressed surprise at the lack of timely solutions to prevent such steep premium hikes impacting many households.
Dr. Mehmet Oz, who oversees the ACA market, stood by the decision to let pandemic-era subsidies expire. He claimed that many consumers should still find plans for less than $50 a month. Oz emphasized the importance of addressing broader healthcare challenges rather than engaging in political disputes, suggesting a need for comprehensive solutions as society moves past the coronavirus crisis.
