In the next few weeks, millions of Americans will open letters from their health insurers and feel their stomachs drop. Health care prices are about to skyrocket again.
Unless Congress acts, families could pay hundreds more every month next year just to keep the same coverage. For many, that means skipping checkups, delaying prescriptions, or deciding which bill not to pay. People are already stretched to the limit—they shouldn’t have to give up care to stay afloat.
Across the country, people are bracing for those letters with a mix of worry and resolve. We’ve been here before. We fought to win the Affordable Care Act because we knew what happens when health costs spiral—families fall behind, hospitals absorb unpaid bills and the workers who keep our health system running, mostly Black and Latina women, carry the burden.
Let’s be honest: America’s health care system wasn’t built to put working people first. But until we build something better, we have to protect what helps families hold on. The Affordable Care Act tax credits are one of those tools—a small but vital lifeline in a system that too often feels rigged against us.
These credits have helped millions of families stay covered and kept health care within reach. Since they were expanded under the American Rescue Plan, more than 21 million people have enrolled in marketplace plans, and the number of uninsured Americans has dropped to record lows.
Letting those credits expire would undo years of progress. Families could see premiums double, especially in rural areas and among older or lower-income people. The Congressional Budget Office warns that over 4 million people could lose coverage altogether.
And those hit hardest? The same workers who keep this country running every single day—home care aides, teachers, bus drivers and janitors who can’t afford to get sick.
Health care workers live this crisis from both sides. They care for patients every day—and many can’t afford care themselves. When premiums go up, they have to choose between staying insured or keeping the lights on. That’s not just bad policy. It’s morally wrong.
This is why working people have marched, rallied and spoken out time and again to protect health care when it’s under attack. No one working full time in the richest country on Earth should have to choose between a doctor’s visit and dinner on the table. But that’s exactly what happens when we treat health care like a luxury instead of a right.
Keeping these tax credits won’t fix what’s broken, but it will keep millions from falling through the cracks while we fight for something better—a health care system that puts people over profits and ensures every person, no matter their job or zip code, can count on care when they need it.
Right now, the federal government has shut down because leaders in Congress have refused to deal with this looming health care crisis. Congress now has a choice. Lawmakers can side with the corporations that profit off pain—or with the people who make this country run.
Working people have carried this nation through every crisis. We’ve shown up, cared for others and kept America going. Now Congress needs to show up for us.
Health care isn’t a privilege. It’s a promise—one this country has yet to fully keep. And until it does, we’ll keep fighting—for our families, our co-workers and a future where everyone in America can afford to get well and stay well.
Linda Goler Blount, MPH, is president and CEO of Community Catalyst.
April Verrett is president of the Service Employees International Union (SEIU), representing more than 2 million workers in health care and the public sector.
The views expressed in this article are the writers’ own.
