Politics isn’t abstract for most Idaho families—it shows up in the monthly budget, the medicine cabinet and the phone calls to health providers. Lawmakers’ choices about taxes, health credits and Medicaid funding determine whether a paycheck stretches to cover groceries, whether a therapy appointment is affordable and whether a sudden crisis lands a family in an emergency room rather than in outpatient care.
Take the state’s recent income tax cuts. In March 2025 Idaho signed House Bill 40, a large reduction in the individual and corporate income tax rates that the governor hailed as “sending money back to Idahoans.” For wealthy households the relief is real and immediate; for the programs that support vulnerable Idahoans, the loss of revenue is already being felt. Analysts warn these cuts disproportionately benefit the top income brackets while weakening the state’s capacity to fund schools, behavioral health programs and other services that cushion household finances.
Those revenue choices have direct consequences for mental health care. Idaho has been facing budget pressures and policy shifts that risk cutting peer-support programs, provider reimbursement and other community-based services that keep people out of costlier emergency care and jails. When state funding tightens, patients often end up paying more out-of-pocket or losing access to steady, preventive treatment.
At the federal level, an equally blunt policy change is about to hit pocketbooks: the temporary expansion of Affordable Care Act premium tax credits, which made marketplace coverage far more affordable, is scheduled to expire at the end of 2025. The result will be big premium increases for many Idahoans who bought plans on the ACA exchanges, with some estimates showing average hikes in the hundreds or even over a thousand dollars per year for households that had benefited from enhanced subsidies. For people managing chronic conditions, mental health needs or family budgets that don’t have room for sudden health costs, that’s a catastrophic difference.
There are positive examples that underscore how policy can improve personal finances. Idaho’s Medicaid expansion brought billions in federal dollars into the state economy and expanded coverage that stabilizes low-income households. Unfortunately, people we keep sending to Boise continue to chip away at it. Smart, targeted public investments save families money in the long run and reduce pressure on emergency services. It’s too bad our so-called representatives don’t think that sort of thing is important.
Politics decides which side of that ledger Idahoans fall on. Cutting taxes for the wealthiest without shoring up the programs that keep vulnerable people healthy shifts costs onto families and local governments. Letting healthcare subsidies lapse will raise premiums and drive some into coverage gaps. The policy choice is clear: short-term tax giveaways for a few, or stable investments that protect the financial security and health of many. If Idaho truly cares about resilient households and a thriving economy, lawmakers would do well to remember that the math of policy shows who pays.
Miranda Marquit is a nationally recognized financial expert, writer and speaker. She is the vice chair of the Bonneville County Democratic Central Committee.