As the Affordable Care Act's enhanced tax credits face expiration, open enrollment in Idaho shows sharp premium hikes that could preview what millions elsewhere will pay if Congress fails to act.
Idaho's state exchange opened Oct. 15, and consumers are seeing steeper prices even before most of the nation begins shopping Nov. 1 on HealthCare.gov.
State regulators say approved 2026 individual health insurance rates rose about 10% on average, while small-group plans rose 11%.
"On average, gross premiums, or the overall cost of the premium, has gone up about 10%," said Pat Kelly, executive director of Your Health Idaho.
"And the net premium, or the amount the consumer pays after the tax credit has been applied, has increased about 75%," or $1,200 annually, he said.
"So those are averages across all of our enrollees, but it does give an indication of overall increase and then increase to what the consumer actually pays."
Even with the tight time constraints, Kelly said he would welcome an extension of the ACA tax credits at any point.
"We stand ready to move mountains, if needed, to make sure that Idahoans receive all the savings that they're eligible for," he said.
The fight centers on whether to keep the pandemic-era expansion of ACA premium tax credits.
Those enhancements, first enacted in 2021 and extended through 2025 by the Inflation Reduction Act, are scheduled to lapse after Dec. 31.
Nonpartisan analyses project that without renewal, what subsidized enrollees pay out of pocket would more than double on average in 2026.
"Premiums are being locked in right now," Sen. Patty Murray, D-Wash., said on Oct. 7.
"Letters are going out to families announcing shocking price increases this month."
She pointed to Idaho's earlier start as a reason for urgency.
Conservatives argue that extending subsidies papers over rising medical costs and expands federal dependency.
The Heritage Foundation contends that extensions are "costly" and do little to restrain premiums, while the American Enterprise Institute warns recent proposals create new "budgetary cliffs."
Analysts across the spectrum forecast real consumer impacts if Congress fails to renew aid.
KFF estimated that average premium payments would jump 114% for subsidized enrollees; the Urban Institute and Commonwealth Fund projected coverage losses numbering in the millions.
Open enrollment begins Nov. 1 in most states; customers generally must choose plans by Dec. 15 for Jan. 1 coverage.
Idaho's earlier start means many residents are already receiving renewal notices, heightening the risk that automatic reenrollment locks in higher costs before any deal is reached.
Democrats say they won't vote to reopen the government until Republicans negotiate an extension of the expanded subsidies.
Republicans say they won't negotiate until Democrats vote to reopen the government.
The Associated Press contributed to this report.
Jim Thomas ✉
Jim Thomas is a writer based in Indiana. He holds a bachelor's degree in Political Science, a law degree from U.I.C. Law School, and has practiced law for more than 20 years.
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