Rising rates, dropped coverage. Idaho's lesson for the rest of America. Ken Alltucker, USA TODAYOctober 31, 2025 at 2:04 AM 0 Brittany Rush's mom and sister, both health care workers, convinced her to get health insurance. When the Boise resident explored options on Idaho's Affordable Care Act marketplace, she was surprised how little she had to pay for coverage. She chose a midlevel silver plan that cost her $4 a month in 2024, a plan she renewed for 2025 for less than $33 a month. To keep the plan in 2026, Rush will need to pay more than $400 a month.
- - Rising rates, dropped coverage. Idaho's lesson for the rest of America.
Ken Alltucker, USA TODAYOctober 31, 2025 at 2:04 AM
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Brittany Rush's mom and sister, both health care workers, convinced her to get health insurance.
When the Boise resident explored options on Idaho's Affordable Care Act marketplace, she was surprised how little she had to pay for coverage. She chose a mid-level silver plan that cost her $4 a month in 2024, a plan she renewed for 2025 for less than $33 a month.
To keep the plan in 2026, Rush will need to pay more than $400 a month.
Because Congress hasn't extended pandemic-era subsidies that made ACA plans less expensive for millions of Americans, many consumers will learn the sticker shock of their 2026 ACA insurance options when signups begin Nov. 1. Congressional Democrats have refused to sign off on a federal spending bill that doesn't extend the subsidies, which has prompted a monthlong federal government shutdown.
Residents of Idaho, which began signups on Oct. 15, already are grappling with higher insurance costs.
Because she could not pay more than $400 a month for coverage, Rush contacted her insurance broker, who found an ACA plan that would cost her about $124 a month. That's still too expensive for Rush, who is juggling costs from her cleaning business and everyday living expenses.
"So my plan right now is to finish coverage through the end of the year, and starting in 2026, I just won't have any health insurance," said the 38-year-old Boise resident. She added she'll likely just pay cash for her doctor next year.
She's among thousands of Idaho residents state officials expect will drop their ACA insurance coverage. A similar scenario will play out nationwide, Congressional budget forecasters said, with more than 4 million expected to lose coverage due to the expiration of the pandemic-era subsidies.
Idaho consumers' insurance costs rise 75%
Idaho's insurance enrollment officials fielded a surge of calls and online chats when the state kicked off enrollment on Oct. 15. The state automatically renewed insurance plans for 2026 and notified consumers via email and regular mail about what they can expect to pay for coverage next year. Consumers have until Dec. 15 to switch or drop plans before coverage begins Jan. 1, 2026.
About 115,000 Idaho residents are enrolled in an ACA health insurance plan and another 20,000 have a dental insurance plan.
State officials project 25,000 Idaho residents will cancel their health insurance because expiring federal subsidies will make them pay a larger share of the plan's price tag, said Pat Kelly, executive director of Your Health Idaho, the state's website where people can sign up for ACA plans. The average ACA insurance plan price tag will rise about 10% in Idaho next year. However, consumers will see their portion of the insurance bill jump 75%, or about $100 more per month, without the enhanced tax credits, Kelly said.
And many states will have steeper insurance premiums spikes than Idaho, said Malia Rogers, an insurance broker in Idaho.
"It's causing a lot of anxiety across the nation," Rogers said.
Unless Congress strikes a deal, the insurance subsidies will revert to original levels of the Affordable Care Act, President Barack Obama's signature 2010 health care law that limited cost-saving tax credits to those who earn up to four times the federal poverty level. Congress temporarily approved more generous, add-on subsidies during the COVID-19 pandemic to ensure more Americans could afford health coverage. The U.S. declared the COVID-19 public health emergency ended in 2023, and the enhanced ACA subsidies are set to expire at the end of 2025.
Because the pandemic-era subsidies are ending, those who earn more than four times the federal poverty level must pay the full cost of their ACA plans. And while lower-income Americans will still qualify for the Obama-era subsidies, they won't get the COVID-era subsidies that sharply reduced their out-of-pocket costs.
Those who earn more than four times the federal poverty level − $62,600 for an individual or $128,600 for a family of four − must pay the entire monthly premium to maintain their ACA coverage.
In Idaho, a family of four earning $130,000 a year will see their health insurance costs rise about $17,000 a year for a mid-level "silver" plan, a "pretty significant impact," Kelly said.
Kelly said the state's ACA enrollment surged 84% since 2022, largely due to the the pandemic subsidies and outreach to consumers.
"We've seen a marked decline in the overall uninsured rate in Idaho, and the enhanced tax credits were a big part of that," Kelly said.
Going without health insurance not an option
McCall, Idaho, resident Cathy Newcomb and her husband are among those who won't get a subsidy. Because the retired couple's income is more than four times the federal poverty level, they will lose the $656 monthly tax credit that has made coverage more affordable.
Their monthly insurance premium will rise from $1,457 to $1,625 − an amount they must pay in full. The more expensive monthly premium combined with the loss of the enhanced subsidy means the amount they must pay will more than double.
Newcomb, 63, had been on employer-sponsored health insurance for decades until that coverage ended in July. She and her husband, Bill, enrolled in an Affordable Care Act plan as a stopgap until they become eligible for Medicare, the federal health program for adults 65 and older.
Going without health insurance isn't an option. Newcomb has Type 1 diabetes, She uses an insulin pump and other supplies that are costly. The Medtronic insulin pump she uses costs more than $10,000, but she anticipates the pump will last until she is eligible for Medicare.
She also needs insulin, continuous glucose monitors, an insulin pump reservoir and an infusion set. She pays about $2,500 every three months for these supplies. They chose a bronze-level ACA plan that has a $7,500 deductible, an amount she must pay before most coverage kicks in.
"We're going to take a 103% increase in the (insurance) premium cost, and I'm still going to be spending $2,500 every three months just to be able to continue my insulin pump therapy," said Newcomb.
Newcomb said she and her husband will be able to handle the rising expenses, but she is concerned about people who can't afford higher insurance costs combined with living expenses. As a member of the Diabetes Patient Advocacy Coalition, she particularly worries about the millions of Americans who need insulin.
About 2 million Americans with Type 1 diabetes take the medication to regulate their blood sugar because their bodies do not produce insulin. Millions more with Type 2 diabetes also take insulin as their disease advances.
Insulin-dependent patients who ration the medication due to cost might face costly and life-threatening health complications.
"Congress can say that they know and they're aware, but they don't live it day in and day out," Newcomb said.
Oz: Covid-era subsidies were a temporary fix
Millions of Americans who are covered by ACA health insurance are learning about the insurance cost spikes residents like Rush and Newcomb experienced.
The federal marketplace, healthcare.gov, on Oct. 29 posted rates and other details on 2026 plans before sign-ups begin Saturday.
The cost for health plans sold on the Affordable Care Act marketplace will rise an average of 26% next year, according to KFF, a health policy nonprofit.
The amount most consumers will pay will rise even more. About 22 million out of nearly 24 million Americans enrolled in ACA plans get subsidies to offset their costs. Because consumers will no longer get the enhanced COVID-era subsidies, their average out-of-pocket costs will more than double, according to KFF.
Because general inflation was such a hot topic during the 2024 presidential election, it is "stunning that there's not quick consensus on preventing premium spikes of this magnitude," said Anthony Wright, executive director of Families USA, an advocacy organization. "This is much bigger than the cost of eggs and other everyday staples."
Dr. Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, which oversees the ACA marketplace, defended the decision to not extend the pandemic-era subsidies.
His agency distributed a fact sheet that said most consumers next year will have access to ACA coverage that costs them $50 or less per month.
During a news conference Wednesday, Oz said the "hair pulling and scratching (and) mudslinging" doesn't address the major issue American health consumers face. He said the Trump administration wants the government reopened to convene experts who can "figure out more holistic ways of dealing with the bigger challenges that we face in America with increasing costs."
He added that the COVID-era subsidies were a temporary measure "to get through COVID. And I think we all agree that COVID has passed, so therefore COVID-era subsidies should also pass."
Email consumer health reporter Ken Alltucker at [email protected].
This article originally appeared on USA TODAY: Americans health insurance costs to spike due to expiring subsidies
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Published: October 31, 2025 at 11:19AM on Source: ALPHA MAG
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