Montana Health Premiums Set to Surge, Families Face Sticker Shock
Enhanced pandemic era premium supports that lowered Affordable Care Act marketplace costs are set to expire at the end of 2025, leaving many Montanans facing steep increases in monthly premiums. Local residents, including self employed families and retirees in Lewis and Clark County, say higher costs could push them to reduce coverage or go without insurance, with older adults and middle income households likely to be hit hardest.
When he logged into the ACA marketplace to renew coverage for 2026, self employed rancher Kirby Walborn saw a worst case example that alarmed him and others across Montana. The family premium quoted in at least one example was roughly $2,400 a month, nearly 270 percent higher than current costs. The potential spike comes as enhanced pandemic era federal subsidies that made many plans affordable are set to expire on December 31, 2025.
About 77,000 Montanans bought coverage through the marketplace last year, and roughly 67,000 of them currently qualify for a federal subsidy that lowers monthly premiums. With that extra federal support scheduled to lapse, many consumers face sudden and large increases in what they must pay each month. Some residents said they are weighing the trade off between paying the new premiums and going without coverage next year. One resident said, "I’m in a bind." One resident said, "I’ve got to have the insurance."
Retiree Jacklynn Thiel, who currently pays no monthly premium because of the enhanced subsidies, reported her plan would jump to $785 a month for a high deductible catastrophic plan, a cost she said she cannot afford. Across the state, experts and households expect middle income families and older adults who no longer qualify for Medicaid to see the largest harm from the change.
The expiration of enhanced subsidies was a central issue in the federal government shutdown that ran from October 1 to mid November this year. Congressional Republicans pushed back on continuing the temporary pandemic era supports, and members of Montana’s congressional delegation publicly opposed expanding them. Policymakers and advocates are now debating alternative proposals, including reforms to health savings accounts and structural changes to the Affordable Care Act, but uncertainty remains large.
For Lewis and Clark County residents, the immediate choices are difficult. Families and small business owners who lack employer based coverage will have to budget for higher monthly costs, seek lower cost plans with higher out of pocket expenses, or risk going uninsured. Until Congress acts or other fixes are put in place, many consumers are preparing for sticker shock when open enrollment begins.
