Sharon Poddick is someone who budgets down to the last dollar. When she lost her job in companywide layoffs a little over a year ago — and with it, her employer-sponsored health insurance — she and her husband started buying health care from Vermont Health Connect, the state’s Affordable Care Act marketplace.
They started to “tighten everywhere we could tighten” when it came to their budget, as Poddick described it. Her car is paid off; she bought her phone refurbished years ago; she’s whittled down expenses wherever she can.
So, when she saw that the subsidies that had made their Affordable Care Act health insurance plan affordable would sunset at the end of 2025, it was like a “tidal wave coming.”
“We were doing well. We were keeping up, and then this hit us,” she said.
Sharon and her husband, Kurt, are among the thousands of Vermonters for whom a steep increase in health insurance premiums is now the reality. The close of 2025 brought the end of the enhanced advanced premium tax credit, which made subsidies for Affordable Care Act marketplace plans available to those earning more than 400% of the federal poverty line and increased the amount of credits. The original subsidies — for those buying marketplace insurance and making less than 400% of the federal poverty line — remain in place.
On Jan. 15, the period for enrolling in health insurance through Vermont Health Connect closed without an extension of those federal subsidies that kept many plans affordable.
The Poddicks waited as long as they could before buying a health insurance plan for 2026 — holding out some hope that the back-and-forth in Washington over whether or not to extend the enhanced premiums could bring some resolution. It didn’t.
Sharon Poddick has since found a new job that she loves, working for a local restaurant group, but her employer is too small to subsidize her insurance. Her husband Kurt is self-employed. They are both 55, and with his job as a contractor, they felt like dropping insurance entirely was not an option.
“It didn’t feel like it was a choice for us. We felt like we had to have some coverage,” Poddick said.
In December they enrolled in the cheapest option available to them: a bronze plan from MVP for $1,700 a month. The deductible is $10,000 for each person.
Just last year they were paying almost half that — $900 — for a gold plan from BlueCross BlueShield of Vermont.
In the first week since enrollment has closed, the state has a first glimpse of how many Vermonters find themselves in a situation like Sharon and Kurt. Early indicators show a health care landscape where many Vermonters may be un- or under-insured.
The numbers of the new landscape
More than 2,500 Vermonters dropped their plans for 2026, data from the Department of Vermont Health Access shows — nearly five times the rate of disenrollment the state saw last year.
With the loss of subsidies, Vermont has collectively lost around $72 million in federal support, Addie Strumolo deputy commissioner of the Department of Vermont Health Access, told legislators in a Tuesday briefing. Originally the department had estimated the state stood to lose $65 million.
Currently, 30,334 people are still enrolled in marketplace plans. Early data from the department shows many cases like the Poddicks’, where people are shifting the types of plans they enrolled in.
About one-third of marketplace enrollees opted for bronze plans this year (the least expensive option), an increase of about 4%-5% from last year. Silver plans (which in Vermont are more expensive than gold plans) saw a dip to 13% of the marketplace share, compared to last year’s 21%. This year, 49% of people are in gold plans — last year, that was 45%.
Strumolo gave lawmakers this data with the caveat that though enrollment has closed, “it takes a while for this all to settle out.” As people receive their initial bills, she expects more to drop their coverage, she said.
The high proportion of gold enrollment is, in part, likely “residual” from last year, she added, describing the state’s push at the time for people to enroll in the plans recently made less expensive than the silver. However, the trend toward bronze is likely a consequence of the high costs without the extended subsidies, she said.
The next step, Strumolo said, is to look at who is dropping their plans to get a better picture of whether Vermonters are underinsured with the plans they now have — meaning, that even with insurance coverage people are still unable to cover their costs of their care.
Mike Fisher, the state’s health care advocate, explained this need for more context: “The question is not actually how many people (enroll) but it’s also about how well they’re sorted,” he told VTDigger.
Not all enrollees are weighted equally in an insurance plan; a good plan relies on healthy people paying more into the pool than they take out in care costs so that people with higher health needs can have their care covered without paying out every single dollar. The health insurance pool is an equalizer, but when healthy, low-cost people leave, it throws off the balance, he said.
And, when premium costs go up, those healthy, low-cost people are often the first to leave the pool.
“Even a small number of people who have low health care costs leaving the market can have a real impact on the costs for the rest of the market,” Fisher said.
The trend creates a vicious cycle of increasing premium costs. Already, insurers predicted a loss of (relatively healthy) enrollees and baked that into their premium increases for 2026. Fisher expects that next year’s premium increases will reflect the reality of the financial hit insurers are taking with how many healthy people drop coverage this year.
‘I have insurance, and I can’t afford to use it’
Fisher worries particularly about the population who have lost the subsidies and are now struggling to pay for their premiums with high deductibles — people like Sharon and Kurt Poddick.
“The story I hear that I hate the most is ‘I have insurance, and I can’t afford to use it,’ and that’s going to happen more,” Fisher said.
At the start of the year, the Poddicks canceled all of their upcoming doctors appointments in an effort to save money. Poddick explained she didn’t want to be caught footing the bill for a lab test or other unexpected costs in a regular visit.
“There’s no annual physical happening; there’s nothing that’s routine. We’ve just cut it out,” she said. “I don’t know if I’m going to be able to pay the doctors when I actually go see them.
“The only reason we’re buying this insurance right now, (is) if we have a major medical situation. Otherwise, you’re financially ruined, but you’re also kind of financially ruined by paying the premium every month,” she said.
The reality of a state full of people who do not receive primary or preventive care weighs heavy on many health care experts — not only because of what it means for the well-being of the individuals who can’t access that care, but also what it means for the financial well-being of Vermont’s health care system.
Earlier interventions and routine primary care can keep insurers and hospitals from footing the bill for more expensive, more advanced health needs — think of routine skin cancer screenings or colonoscopies compared to the costs of treating a progressed cancer. It’s part of why lawmakers in Montpelier are trying to prioritize primary care in proposed legislation this session.
When people do face inevitable health care emergencies, they often land in a hospital’s emergency room, regardless of if they have insurance. Hospitals end up bearing the costs when treating patients unable to pay for care.
The loss of any revenue could be catastrophic for Vermont’s already financially precarious hospitals, Owen Foster, who chairs the Green Mountain Care Board, explained to legislators in October.
Though the scope of what the loss of subsidies will mean for the state is broad and sweeping, what it means for an individual is a daily, detailed management.
Sharon Poddick is trying to pick up extra hours working a part-time job in the evenings, to supplement the new full-time job she’s found working for a local restaurant group. Her husband, the contractor, is trying to do the same by taking on a few more projects.
Each month, paying the premium is a little victory. “We celebrated having January covered,” Poddick said. “I don’t know about February, but we try to do what we can with the premium and just take it month to month.”
