Brittany Rush’s mom and sister, both health care workers, convinced her to get health insurance.

When the Boise resident explored options on Idaho’s Affordable Care Act marketplace, she was surprised how little she had to pay for coverage. She chose a mid-level silver plan that cost her $4 a month in 2024, a plan she renewed for 2025 for less than $33 a month.

To keep the plan in 2026, Rush will need to pay more than $400 a month.

Because Congress hasn’t extended pandemic-era subsidies that made ACA plans less expensive for millions of Americans, many consumers will learn the sticker shock of their 2026 ACA insurance options when signups begin Nov. 1. Congressional Democrats have refused to sign off on a federal spending bill that doesn't extend the subsidies, which has prompted a monthlong federal government shutdown.

Residents of Idaho, which began signups on Oct. 15, already are grappling with higher insurance costs.