Open enrollment for Affordable Care Act (ACA) health plans opened Wednesday in Idaho, giving Americans an early look at how sharply premiums are set to rise in 2026.
For many Idaho families, the upcoming year could bring difficult decisions about whether they can afford to keep their health insurance as enhanced federal subsidies are set to expire.
Families Facing Steep Increases
Bob and Leslie McMichael, a retired couple from Idaho, are already bracing for the impact. Living on an annual income of about $42,000, they currently pay $51 a month for their ACA plan.
But next year, without the federal subsidies, their monthly premium is expected to skyrocket to $2,232 — an increase they say makes coverage impossible to maintain.
Subsidies on the Line
The enhanced ACA subsidies, introduced in 2021 to make health coverage more affordable, are set to end on December 31. The future of those subsidies has become a central issue in the ongoing government funding standoff in Washington.
Democrats are pushing to extend them, while many Republicans are reluctant to continue the costly tax credits without broader spending reforms.
What the Numbers Show
According to Idaho health officials, the expiration of subsidies would raise average out-of-pocket premiums by about $1,200 per year — a 75% increase. “A pretty big number of people are going to see their premiums double, if not more,” said Hillarie Matlock, policy director at Idaho Voices for Children, which advocates for affordable health care access across the state.
Widespread Impact Across Idaho
This year, more than 100,000 Idaho residents — roughly 87% of all ACA enrollees — benefited from the enhanced subsidies, according to data from the Centers for Medicare and Medicaid Services.
State officials estimate that about 25,000 people will likely drop their insurance coverage altogether next year if the subsidies are not renewed before year’s end.
State Preparations Underway
Pat Kelly, executive director of Your Health Idaho, the state’s health insurance marketplace, said his team has spent the past year preparing for the potential loss of subsidies.
“We’ve trained agents on what these changes will mean and how to help consumers understand their options,” he said. Still, Kelly acknowledged that many Idahoans may be priced out of coverage.
The Broader Financial Picture
Gideon Lukens, a senior fellow at the Center on Budget and Policy Priorities, said middle-class families will feel the brunt of the change. “A 60-year-old couple earning $85,000 a year in Idaho could see about a $1,500 increase in monthly premiums,” he explained.
For a family of four earning $130,000, the hike could reach $650 a month — and “that’s not an outlier.”
Real-Life Consequences
For many residents, the uncertainty is already changing behavior. “We’ve heard from people rushing to get appointments and procedures done before the end of the year,” said Matlock. “They’re worried they won’t be able to afford preventive care next year.”
Even those who don’t qualify for subsidies are seeing premium increases averaging 18% due to insurer rate hikes.
Small Business Owners Hit Hard
Mark and Sarah Lathrop, small-business owners from Coeur d’Alene, fall into that category. The couple, who own Liberty Lake Wine Cellars in nearby Washington, currently pay $1,116 a month for their ACA plan.
Their 2026 renewal notice shows premiums rising to $1,351 — a 21% jump — while their annual out-of-pocket maximum will soar from $12,000 to $18,400.
Hard Choices Ahead
The Lathrops have already tightened their budget, cutting back on dining out, travel, and other discretionary expenses. Despite the cost, they plan to keep their coverage because Mark has a medical condition that requires annual monitoring.
“I don’t think our situation is as bad as some others losing tax credits,” he said. “But it’s going to hit small-business owners hard.”
A Preview for the Nation
As Idaho’s enrollment period begins, the rest of the country is watching closely. The state’s early open enrollment serves as a bellwether for what other Americans may face in 2026 if Congress fails to extend the ACA subsidies.
For many families, the coming months could determine whether affordable health care remains within reach — or becomes a luxury once again.
