Many Vermonters are facing the harsh reality of losing affordable health insurance in 2026 – a situation that could significantly impact their well-being and financial stability. But here's where it gets controversial: the decision to roll back subsidies and the subsequent rise in insurance costs is sparking heated debates about the future of healthcare affordability in Vermont.
Take Sharon Poddick, for example. She is someone who plans her finances meticulously, making sure every dollar is accounted for. After losing her job over a year ago—along with her employer-sponsored health insurance—she and her husband turned to Vermont Health Connect, the state's health insurance marketplace established under the Affordable Care Act, to find coverage.
In her own words, Sharon explains that they've been extra cautious with their budget, paying off her car and opting for refurbished phones to cut costs wherever possible. Yet, the looming end of the subsidies that kept their health plans affordable felt like an impending catastrophe, akin to a 'tidal wave' washing over their financial stability. When they first enrolled, the subsidies helped make their health insurance manageable, but those subsidies are set to expire at the end of 2025, sharply increasing premiums.
The Poddicks, along with thousands of other Vermonters, are now confronting the reality of much higher health insurance costs after the federal enhanced premium tax credits—funds that helped those earning above 400% of the federal poverty level—ended. The original subsidies, which helped those earning less than 400%, continue to exist, but the loss of the additional support has resulted in many paying far more out-of-pocket for their health coverage.
By mid-January, the deadline to enroll in 2026 coverage on Vermont Health Connect had passed, and no extension was granted for the federal subsidies. Sharon and her husband held out hope that ongoing political discussions in Washington about extending these subsidies might bring relief. Unfortunately, the uncertainty persisted, and they had little choice but to select a cheaper plan.
Recently, Sharon secured a new job at a local restaurant group, which she enjoys. However, her new employer is too small to offer insurance benefits, and her husband, a self-employed contractor, faces similar hurdles. Both are in their fifties—and with Kurt’s contracting work showing inconsistent income—they felt that dropping insurance entirely was not a feasible option.
In December, they opted for the most affordable plan they could find—a bronze plan from MVP costing $1,700 per month, with a hefty deductible of $10,000 per person. Last year, their coverage was approximately half that, with a gold plan from BlueCross BlueShield of Vermont costing $900 a month.
In the first week after open enrollment ended, early data reveals a concerning trend: many Vermonters find themselves underinsured or completely uninsured. Over 2,500 residents have already dropped their plans for 2026—a staggering increase compared to last year's disenrollment rate. The Department of Vermont Health Access reports these numbers, emphasizing how the loss of subsidies has deeply affected the financial landscape for many.
This shift has also led to the state losing roughly $72 million in federal support—a notable blow, considering initial estimates projected a loss of around $65 million. Currently, about 30,334 people remain enrolled in marketplace plans, but the types of plans they choose have shifted markedly.
Data shows an increase in the number of enrollees opting for the cheapest options: about one-third chose bronze plans for the upcoming year, a modest rise from last year. Conversely, the percentage of enrollees in silver plans has decreased from 21% to 13%, while gold plans now attract nearly half of the marketplace share, up from 45%. This pattern suggests that many are switching to plans they can afford, even if they may not cover all their medical needs comfortably.
Addie Strumolo, deputy commissioner of Vermont’s Department of Health Access, explains that it takes time for these enrollment patterns to stabilize after the subsidy changes. She anticipates more cancellations once people receive their bills and assess whether their plans are truly affordable. The high reliance on gold plans—likely a residual effect from last year’s push for cheaper alternatives—may also reflect people’s efforts to lock in better coverage amidst rising costs.
A crucial concern raised by health policy experts is whether Vermonters are underinsured even when they do have coverage. Mike Fisher, Vermont’s healthcare advocate, emphasizes that insurance is most effective when it covers costs without leaving patients vulnerable to catastrophic expenses. When low-cost, healthy individuals leave the pool—often in response to soaring premiums—the overall system becomes less balanced.
This deterioration can trigger a vicious cycle: insurers anticipate the departure of healthier enrollees and raise premiums accordingly, further encouraging this outflow. Consequently, premiums for the next year are expected to increase because insurers are absorbing higher costs due to the loss of low-risk patients.
For many, especially those who have lost assistance like Sharon and Kurt, the situation is dire. Fisher highlights the scenario where people have insurance but cannot afford to use it—an irony that frustrates both patients and caregivers. Sharon describes how they’ve canceled routine checkups and elective visits, fearing the cost of unexpected tests or treatments. She admits that their insurance mainly exists as a safety net for emergencies, but the reality is that many avoid necessary care altogether to prevent financial ruin.
This avoidance could have broader repercussions—not only jeopardizing individual health but also placing long-term strain on Vermont’s healthcare system. Preventative care, which often costs less and can prevent severe health issues, becomes less accessible, leading to more emergencies that hospitals must treat without guaranteed reimbursement.
Vermont's hospitals, already in a financially fragile state, may face even greater struggles if reimbursement streams diminish further. Owen Foster from the Green Mountain Care Board warns that losing revenue from uncompensated care could be devastating for local hospitals, which are vital to the health of entire communities.
On a day-to-day level, Sharon and her husband are scrambling to make ends meet. She’s putting in extra hours at her new job, while Kurt is trying to pick up additional projects on the side. For now, paying their monthly premium is a victory—something they celebrate, even if they aren't sure about their ability to handle future bills. Sharon shares, "We celebrated having January covered; I don’t know about February, but we’re taking it one month at a time."
And this is the part most people miss: the shifting landscape of healthcare affordability in Vermont is not just a political issue—it's a matter of real lives, real struggles, and difficult choices. As the state and federal government continue to debate policies, one question remains: Are we truly doing enough to keep healthcare accessible and affordable for all Vermonters? What do you think? Are these changes justified, or are they placing too many Vermonters at risk? Share your thoughts below.
