Idaho Just Showed America What Happens When Health Subsidies Vanish

Nearly 9,000 Cancel Plans in One State

Idaho just became the first state to close health insurance enrollment for 2026, and the numbers are not good.

Nearly 8,850 people canceled their plans on the state exchange, double the cancellations from last year. Another 20,000 are expected to drop coverage in the coming months.

The problem is federal subsidies that made insurance affordable for five years are expiring on December 31, and Congress has done nothing to extend them.

What is happening in Idaho right now is about to happen everywhere else.

Cancellations Double in Idaho

Idaho’s health insurance exchange ended open enrollment on December 15 with more than 120,000 people enrolled in plans, a 3% increase over last year.

But the good news ends there. The exchange saw nearly 8,850 people cancel their coverage, twice as many as the year before.

New enrollments dropped 24%, and more people shifted to cheaper plans with higher out-of-pocket costs.

Exchange director Pat Kelly said affordability was the driving concern for Idahoans shopping for coverage this year.

20,000 More May Drop Soon

The cancellations so far are just the beginning. Kelly said he expects another 20,000 Idahoans will cancel coverage in the coming months due to affordability concerns.

It will likely take until April for enrollment to settle, as people figure out whether their premiums fit in their budgets and insurers cancel policies for nonpayment.

Many people who enrolled may try to make the first few payments, realize they cannot keep up, and let their coverage lapse.

What the Subsidies Actually Did

The American Rescue Plan Act of 2021 expanded eligibility for premium tax credits and increased the amount of financial assistance provided.

People with income at or below 150% of the federal poverty line could enroll in Silver plans with zero-dollar premiums.

The credits also made those earning more than 400% of the poverty level newly eligible for help, removing what was called the subsidy cliff.

The Inflation Reduction Act extended these enhanced subsidies through the end of 2025.

Idaho Saved $407 a Month

In Idaho, the credits reduced premiums by an average of $407 each month, according to the nonpartisan health policy group KFF.

About 87% of Idahoans who have insurance through the state exchange received the credits. For many families, that was the difference between having coverage and going without.

One single mother earning $75,000 a year said her kids’ premiums were set to jump $200 a month even before she lost eligibility due to a small raise at work.

Congress Lets Credits Expire

Enhanced premium tax credits are set to expire at the end of this year unless Congress renews them. The cavalry is not coming.

While the House is expected to vote in January on a Democratic proposal to extend them for three years, the effort faces significant hurdles in the Senate.

Congress appears on track to let the tax credits expire, as Republican leaders pursue legislation to address health care costs without extending the credits.

Idaho Senators Vote No

Idaho Sen. Mike Crapo cosponsored a bill to address rising health insurance costs, but it would not extend the enhanced tax credits.

Crapo and fellow Republican Sen.Jim Risch voted against a Democratic bill that would have extended the credits for three years.

Crapo blamed Democrats for creating a system that shifted costs from enrollees to taxpayers. Risch could not be reached for comment.

Neither senator supported keeping the subsidies that had lowered premiums for 87% of their constituents.

Fewer First-Time Enrollees

In Pennsylvania, in the first six weeks of open enrollment there was a 16% decrease in people signing up for the first time compared with last year.

Idaho saw a similar pattern with 24% fewer new enrollments.

Most of those canceling earned 150% to 200% of the federal poverty level, or $23,475 to $31,300 for a single adult.

These are working people who earn too much for Medicaid but not enough to absorb a major premium increase.

Cheaper Plans Cost More Later

Many Idahoans did not cancel outright but shifted to cheaper plans.

These plans have lower monthly premiums but come with higher deductibles, copays, and out-of-pocket maximums.

That means if you actually need medical care, you pay more before insurance kicks in. For healthy people, it might work.

For anyone with a chronic condition or an unexpected illness, the savings on premiums can disappear fast when the bills come.

Premiums Double Nationwide

If enhanced tax credits expire, the average subsidized enrollee would pay $1,904 in premiums in 2026 instead of $888, a 114% increase.

About 23% of ACA marketplace enrollees in a KFF survey already said it is very difficult to afford out-of-pocket premiums.

If premiums doubled, 25% of respondents said they would be very likely to go without insurance entirely.

The original ACA subsidies will remain, but they are far less generous.

22 Million Rely on Help

Roughly 22 million Americans receive the enhanced subsidies, which lower the cost of their ACA insurance premiums.

The enhanced subsidies helped draw a record 24.3 million people to sign up for 2025 policies. Four out of five consumers were able to find 2025 plans for $10 or less a month.

Without the credits, millions will face the same choice Idahoans are making right now: pay more, switch to worse coverage, or go without.

This article was created with AI assistance and human editing.

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