| Idaho residents who rely on the state’s health insurance exchange had a rude awakening yesterday. As the first people in the country to begin picking their coverage for 2026, they’re confronting the sticker shock that’s at the root of the US government shutdown. It’s not pretty. Julie Schrader’s mind started racing when she learned her bronze plan’s premium would jump to nearly $800 a month — a $255 increase. That includes a deductible of more than $8,000 before the coverage kicks in. The 62-year-old psychiatric nurse practitioner from Boise can’t just drop the insurance. Her wife is on disability with cancer. “I’m nervous about additional expenses cropping up,” including surgeries, prescriptions and imaging tests, says Schrader, who’s already working all the hours she can handle. Pat Kelly, executive director of Your Health Idaho, expects about 25,000 people to drop their health plans because of rising premiums. That’s about 20% of the platform’s approximately 135,000 users. The fight in Congress is over whether to extend tax credits — now expiring — that were sweetened and offered to more people during the Covid pandemic. Republicans, concerned about the national debt, say no. Democrats, concerned about the cost of health care, say yes. They haven’t found a compromise. The expanded tax credits helped more than double the number of people covered by the Affordable Care Act exchange plans to about 24.3 million in 2025, says Charles Gaba, a health-care policy and data analyst who runs ACASignups.net, which has tracked enrollment and premiums since 2013. Boise-based Lori Shandro, a 20-year veteran insurance broker, is having heavy conversations with clients about how they’ll adjust. She’s concerned higher prices will force them to choose between buying insurance and putting food on the table. “People can’t even really understand how it’s going to affect them,” she says, citing a frustratingly complicated system that’s hard to explain until people sit down with real numbers. “We’re going back to those calculations and life choices.” In other words, it’s not an abstract fight in Washington anymore, says Emma Wagner, a senior policy analyst with the Kaiser Family Foundation. Most people on the exchanges receive some sort of federal help to help pay for premiums, she says. “It’s really come home to people’s pocketbooks,” she said. “People have to make some hard decisions about how they’re going to afford their health coverage in 2026.” While Idaho is first, larger swaths of people will be hit in other states, including Texas, California and Georgia, where more people get insurance through the marketplace. The federal site program, HealthCare.gov, doesn’t go live with updated information and enrollment until Nov. 1. Many younger, healthier patients may forego insurance and roll the dice on their health. That’s driving up prices for the older, sicker people who remain, as insurers boost premiums to make sure they are covering their costs. The tax credit expiration is expected to more than double the average annual premiums for enrollees that use them, to $1,904 a month in 2026 from $888 a month this year, according to an article from KFF. The nonpartisan Congressional Budget Office says keeping the enhanced subsidies would cost $350 billion over a decade. For the moment, Idaho’s previewing what’s to come nationwide. — Uma Bhat | 
