HELENA — In 2025, more than 77,000 Montanans got health insurance through HealthCare.gov. The vast majority of them – around 69,000 – got some form of assistance to lower their costs. That means many of them could soon be paying more, if they keep their plans into 2026.
(Watch the video for more on what could be changing with Affordable Care Act subsidies.)
Since the start of the Affordable Care Act, there have been tax credits to help some people pay premiums for health coverage on the insurance marketplace. During the COVID pandemic, the federal government increased those credits and expanded who’s eligible for them. Now, though, the “enhanced premium tax credits” are set to expire on Jan. 1.
Congress has been debating possible legislation to address expected premium increases, but so far, Republicans and Democrats haven’t been able to agree on a proposal that can pass both the House and Senate. That means it’s very likely the subsidies will run out, at least for now.
An analysis from KFF Health News said an average marketplace premium could double if the enhanced tax credits expire.
According to data from the federal Centers for Medicare and Medicaid Studies, the average tax credit for the 68,707 Montanans receiving them in 2025 was $543, and the average premium for those recipients afterwards was $102.
Not everyone will be affected equally if the enhanced subsidies expire. Advocates say one group that will be hit particularly hard is those making more than four times the federal poverty rate – about $63,000 for an individual or $129,000 for a family of four – who will no longer qualify for the tax credit. CMS data shows 12,428 Montanans enrolled in marketplace health plans for 2025 earned more than that income limit and would not be eligible for the tax credit without the expansion.
Last week, the U.S. Senate voted on two competing proposals to address the upcoming premium increases, but neither could get the 60-vote supermajority needed to move forward. Democrats had proposed extending the subsidies for three more years, saying it was the best option for preventing further cost increases. Most Republicans, including Montana’s two senators, favored a bill that didn’t extend the subsidies but instead put more money into health savings accounts – arguing it would be better to deliver that money directly to the public.
“As we work to lower the sky-high health care costs caused by Obamacare, we should prioritize empowering consumers, providing relief directly to hardworking American families, and increasing competition and transparency rather than continuing to give hundreds of billions of dollars in taxpayer money to health insurance companies that keep jacking up rates on the American people while their stock prices soar,” Sen. Tim Sheehy said in a statement to MTN.
Sen. Steve Daines was the only member of the Senate who didn’t vote on the two health care proposals last Thursday. A spokesperson for his office said Daines was traveling with a congressional delegation outside the country, but that he supported the Republican legislation.
On Wednesday, the U.S. House passed a Republican health care bill that would reduce some ACA premiums and make other reforms, but would not extend the subsidies. Both of Montana’s House members, Republican Reps. Ryan Zinke and Troy Downing, voted in favor. It’s still not clear if the bill, which received no Democratic support, could clear the 60-vote hurdle in the Senate.
Regardless of what happens with the tax credits, many insurers were already expected to increase premiums for ACA health plans this year due to increased costs. Advocates say, with higher costs this year, they’re expecting more Montanans will opt for plans with lower premiums but higher deductibles.
Dec. 15 was the deadline to sign up for a plan on HealthCare.gov and receive coverage starting Jan. 1. However, the open enrollment period will remain open through Jan. 15.
