Last month, Democrats in Congress refused to support a government funding extension bill over concerns some Americans would see major price increases in their health insurance premiums due to the impending expiration of tax credits that help lower-income Americans afford coverage.
Now, 23 days into the shutdown, some Americans are starting to see those fears realized.
Open enrollment for the Affordable Care Act (ACA) insurance marketplace in Idaho began Oct. 15, making it the first state in the nation to allow consumers to sign up for plans while the tax credits remain in limbo.
According to Pat Kelly, executive director of the state’s ACA exchange “Your Health Idaho,” gross premiums for health insurance plans are up an average of 10% versus last year. But net premium costs — the amount consumers pay after tax credits and other benefits are applied — are up about 75% on average, or $100 per month.
That number varies widely depending on an individual’s income, family makeup and type of plan. An Idaho couple earning under 400% of the federal poverty level, or $84,600 in 2026, who purchase a mid-level silver plan can expect their annual premiums to increase by about $18,000, Kelly said. A family of four who earn under $128,600 will see an increase of about $17,000.
Moreover, experts are concerned the premium cost increases will push some younger and healthier people to drop their insurance plans altogether, driving up costs for everyone as insurers are forced to cover more people requiring expensive care.
“We're certainly concerned any time there is an increase in the uninsured in Idaho,” Kelly told Scripps News in an interview Thursday. “How it will impact rates going forward, I think it's too early to tell.”
The so-called enhanced premium tax credits were established in the wake of the COVID-19 pandemic by the American Rescue Plan Act in 2021, and extended through 2025 by the Inflation Reduction Act. According to those laws, households with incomes less than 400% of the federal poverty level can receive tax credits to help offset the cost of their health insurance premiums.
But even those who earn more than 400% of poverty level will see their subsidies decrease should the tax credits expire.
“Everyone that receives a tax credit in 2025 will be impacted,” Kelly said.
And Idaho is among the states expected to be least impacted by the tax credit expirations, according to an analysis by the health policy research firm KFF.
Americans in Wyoming and parts of West Virginia, Connecticut and Illinois are set to see the greatest increases in premium costs, the analysis found, with spikes ranging from $600 to $4,000 per month on the horizon.
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While some Republicans in Congress have signaled an openness to starting a conversation about extending the subsidies, all have held firm that no such discussions can take place until after government shutdown ends.
“The government needs to open up and then we’re happy to talk about any other issues the Democrats want to talk about,” Senate Majority Leader John Thune (R-SD) told reporters earlier this week. “I think the president is willing to sit down... but open up the government and that can happen.”
White House officials, meanwhile, have sought to portray the coming subsidy cliff as Democrats’ fault, given their longstanding support for the ACA.
“I'll just point out the irony in Democrats holding the government and the American public hostage over a health care system that they created,” White House Press Secretary Karoline Leavitt said Thursday. “Republicans have always said it's a broken system, yes, but they caused it, and now they want to shut down the government. To fix it, we need to open the government, and then we can have these very important conversations about health care.”
Congressional Democrats, for their part, by and large believe that the coming price increases will only strengthen their hand in the shutdown fight. While open enrollment in Idaho began in mid-October, most other state exchanges will open on Nov. 1 — at which point the scope and scale of a premium increase will become more clear.
According to Sen. Patty Murray (D-WA), the top Democrat on the Senate Appropriations Committee, Republicans will own the price increases due to their “refusal to act.”
“If Republicans don't want to level with their own constituents about what is at stake, I'm happy to do it,” Murray said at a news conference last week. “Republicans may well be able to shut down the government, but they cannot shut down the debate, and they cannot shut out the voices of families who are facing the harsh reality of their inaction.”
Indeed, a recent KFF analysis found that 80% of all ACA premium tax credits went to consumers in states President Donald Trump won in in the 2024 election.
To that end, a group of 13 House Republicans facing difficult reelection contests penned a letter to House Speaker Mike Johnson (R-LA) on Tuesday urging swift action to address the expiring tax credits.
“Millions of Americans are facing drastic premium increases due to short-sighted Democratic policymaking,” the lawmakers wrote. “While we did not create this crisis, we now have both the responsibility and the opportunity to address it.”
But those lawmakers too said they wouldn’t support such measures until the shutdown concluded. And with Democrats are holding firm that they won’t vote to reopen the government until the ACA subsidy issue is addressed, the shutdown appears likely to drag on with no end in sight.
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