Thousands of Montana residents who purchase health insurance through the federal marketplace are facing staggering premium increases for 2026, with some seeing their monthly costs nearly quadruple. The dramatic price hikes are the direct result of enhanced financial subsidies, first introduced during the pandemic, which are set to expire at the end of 2025.
For many self-employed individuals, early retirees, and families without employer-sponsored coverage, the end of this support is creating an immediate financial crisis, forcing them to consider dropping coverage altogether or diverting funds from essential savings.
Key Takeaways
- Enhanced Affordable Care Act (ACA) subsidies are expiring at the end of 2025, causing a sharp rise in insurance premiums for 2026.
- Some Montana residents report their monthly premiums are set to increase by nearly 270%, from hundreds to thousands of dollars.
- The loss of subsidies disproportionately affects older adults who do not yet qualify for Medicare and earn above 400% of the federal poverty level.
- Faced with unaffordable costs, some are choosing to go uninsured, risking potential medical bankruptcy, while others are pulling from retirement savings.
A Financial Cliff for Montana Families
Approximately 77,000 Montanans relied on the ACA marketplace for health coverage last year. Of those, about 67,000 received subsidies that made their plans affordable, with an average monthly discount of $545 in the current year.
The enhanced subsidies, however, are now ending. This policy change creates what many describe as a "financial cliff," particularly for older adults who make too much to qualify for traditional aid but are not yet 65 and eligible for Medicare. Health experts note that those earning more than 400% of the federal poverty level—about $85,000 for a two-person household—will be hit the hardest.
By the Numbers
- ~270%: The premium increase one Montana rancher faces for 2026.
- 77,000: The approximate number of Montanans who used the ACA marketplace for insurance last year.
- $545: The average monthly subsidy discount for qualifying Montana residents this year.
- $2,400: The new estimated monthly premium for a family plan that previously cost $650.
Kirby Walborn, a 63-year-old rancher from Busby, has used the marketplace for years to insure himself and his wife. Their current premium is about $650 per month. For 2026, that same plan is projected to cost roughly $2,400 a month.
"It’s kind of a shocker, but I’m in a bind. I can’t go without," Walborn said, citing a chronic health condition and the physical risks of ranching. "I’ve got to have the insurance."
Impossible Choices: Debt or No Coverage
The sudden affordability crisis is forcing residents into difficult decisions. Many are now weighing the immense risk of going uninsured against the certainty of financial strain.
Jacklynn Thiel, a 61-year-old retired state employee from Boulder, currently pays no monthly premium thanks to the enhanced subsidies. Next year, a high-deductible catastrophic plan would cost her $785 a month. Faced with this new expense, she has decided to forego coverage.
"I’m not going to get insurance unless the subsidies change," Thiel stated. "If I have no insurance and then go into the hospital, they’ll still treat me and I’ll claim medical bankruptcy. I think medical bankruptcy is the better option."
What Were the Enhanced Subsidies?
Originally passed as part of pandemic relief legislation, the enhanced subsidies expanded eligibility for financial assistance on the ACA marketplace. They eliminated the "subsidy cliff," ensuring no one paid more than 8.5% of their income on a benchmark plan, and increased aid for lower-income individuals. This policy is set to expire on December 31, 2025.
Others, like Timothy Stevens of Livingston, are reallocating funds to cover the increase. The 58-year-old and his wife will see their monthly premium jump from $1,200 to over $2,800. To manage this, they plan to stop contributing to their retirement accounts.
"I realized, wait a minute, I’m the person that they’re talking about," Stevens said, recalling the recent federal budget debates. "If we can’t take care of our health care, I mean, like what is this country coming to?"
Political Stalemate Leaves Consumers Exposed
The question of extending the subsidies has become a point of contention in Washington. The issue was central to a federal government shutdown debate, where Congressional Democrats advocated for an extension while Republicans argued the discussion should be separate from government funding.
Montana’s all-Republican congressional delegation has voiced strong opposition to continuing the expanded subsidies. They argue the payments benefit insurance companies and contribute to rising healthcare costs, a problem they attribute to the Affordable Care Act itself.
In a November interview, Rep. Troy Downing, Montana's former insurance regulator, downplayed the impact of the expiring aid. He suggested the pandemic-era support made up a "really small amount" of total subsidies and that "most of those folks are going to be just fine with or without that."
Walborn, the rancher facing a nearly $1,800 monthly increase, sent an email to Rep. Downing's office, urging him to support an extension. He wrote that losing the support would mean "choosing between healthcare and other basic needs."
The response from Downing's office noted that the subsidies were a temporary pandemic measure and stated, "Clearly, the pandemic is well behind us."
Searching for Alternatives
As the deadline to enroll for 2026 coverage approaches, no federal proposal has emerged to prevent the sharp cost increases. During a recent Senate Finance Committee hearing, Sen. Steve Daines criticized the ACA but offered few specifics on immediate relief for consumers.
Instead, some Republicans have proposed alternative policies, such as expanding the use of pre-tax Health Savings Accounts (HSAs). Free-market advocates suggest this would put consumers in charge of their healthcare decisions rather than funneling subsidies to insurers.
However, with the December 15 deadline for January 1 coverage looming, these long-term policy debates offer little comfort to Montanans facing immediate financial pressure. For now, they are left to navigate a marketplace where affordability has suddenly vanished.
