Montana Faces ACA Premium Surge as Pandemic Subsidies Expire in 2026

Montana health insurance marketplace enrollees face significant premium increases in 2026 due to the expiration of pandemic-era enhanced subsidies. Self-employed individuals and older adults earning above 400% of the federal poverty level are particularly affected, with some seeing premium hikes of up to 270%. This surge results from the end of temporary federal financial support initially introduced to ease costs during the COVID-19 pandemic. Currently, approximately 77,000 Montanans rely on the Affordable Care Act (ACA) marketplace for coverage, with around 67,000 qualifying for subsidies. The average monthly subsidy this year is $545, but many will lose this aid by 2026, complicating affordability for middle-income families. Affected residents, including self-employed rancher Kirby Walborn and retired state employee Jacklynn Thiel, describe financial distress leading some to consider foregoing insurance altogether. This trend raises concerns about increased uninsured rates and the potential impact on health outcomes and emergency care needs. The subsidy debate was central to the federal government shutdown from October to November 2025. Congressional opposition, especially among Montana's Republican delegation, has focused on skepticism regarding the ACA's role in rising healthcare costs and resistance to continuing expanded subsidies. Senator Steve Daines and other Republican lawmakers propose alternatives like expanding Health Savings Accounts (HSAs) to manage healthcare expenses, advocating for market-driven solutions over direct insurance subsidies. However, concrete alternative policies to maintain insurance affordability have yet to be fully articulated or implemented. The policy impasse leaves many Montanans scrambling for financial solutions or choosing to remain uninsured, which could stress emergency healthcare systems. The ACA marketplace enrollment for plans starting January 1, 2026, has a deadline of December 15, heightening urgency. Industry experts note that the sunset of enhanced subsidies reveals structural challenges in the U.S. health insurance market, emphasizing a need for sustainable policy reforms that balance cost control with access. The unfolding situation highlights ongoing partisan divisions over health insurance policy, with significant implications for coverage stability, consumer protection, and the economic well-being of middle-income Americans who do not qualify for Medicaid or Medicare but rely on marketplace products.