Editor's note: Este artículo está traducido al español.
U.S. Rep. Susie Lee, D-Nev., is leading dozens of House Democrats in urging congressional leadership to extend enhanced Affordable Care Act premium tax credits before they expire at the end of the year.
“If this tax credit is allowed to expire, premiums for working-class families on the individual market will skyrocket next year, with a typical family seeing their insurance bills nearly double,” reads a letter delivered Thursday to House Speaker Mike Johnson, R-La.; House Minority Leader Hakeem Jeffries, D-N.Y.; Senate Majority Leader John Thune, R-S.D.; and Senate Minority Leader Chuck Schumer, D-N.Y.
Lee and Rep. Kristen McDonald Rivet, D-Mich., spearheaded the letter.
The push comes as Congress faces a Sept. 30 deadline to pass legislation to fund the federal government and avoid a shutdown. Democrats, in the minority in both the House and Senate, have pressed for bipartisan negotiations on the continuing resolution to keep the government operating, aiming for an extension of the credits for Americans who get health insurance through ACA marketplaces.
The subsidies were first approved in 2021 during the COVID-19 pandemic and extended under the 2022 Inflation Reduction Act, but they are set to expire at the end of 2025.
This summer’s “One Big Beautiful Bill” budget legislation did not include an extension of the credits,
More than 4 million people could become uninsured by 2034 if the enhanced premium credit expires at the end of the year, according to the Congressional Budget Office. Add to that the projected increases in health care costs across the board, and a crisis is looming, Lee said.
“Health insurance is just going to become unbearable for families across this country,” Lee told the Sun. “Insurance rates are going to go up for everyone, not just people who are on the exchange and benefiting from these tax credits.”
Nearly 100,000 ACA marketplace enrollees in Nevada currently benefit from an average $465 a month in credits, according to the Kaiser Family Foundation.
Lee said Republican lawmakers, particularly those in battleground districts, have expressed some nervousness about the credits expiring.“The question is: Are they willing to stand up and fight?” Lee asked of Republicans.
Politico reported Monday that some Senate Republicans are interested in extending the credits “with policy changes designed to win over conservatives.” Some House Republicans also backed legislation stretching the credits for an additional year.
Lee said she had not spoken with Rep. Mark Amodei, the sole Republican in the Nevada congressional delegation, about the ACA credits.
The letter comes only weeks before the Nevada Division of Insurance publishes approved health insurance rates for Nevada Health Link, the state’s ACA marketplace, on Oct. 1. Rate submissions from the individual market proposed an average 17.5% increase in premiums for the ACA policies, the division wrote in July.
Open enrollment for Nevada Health Link begins Nov. 1.
Nevada Reps. Steven Horsford and Dina Titus were among the 36 Democrats signing the letter to the congressional leaders.
The likelihood of the credit extension being included in a continuing resolution is dimming. A House GOP plan that would keep the government funded at current levels is scheduled for a vote today. It does not extend the credits. Johnson has said he has the votes in his caucus to pass the legislation without Democratic support.
In the Senate, however, current rules would require that at least seven Democrats join the full Republican majority for passage in the upper chamber.
Whether it’s in a spending bill to avoid a government shutdown or standalone legislation later this year, Lee said she does not care how an extension of the credits gets through the Republican-controlled Congress, just that it does.
She also noted that this additional financial pressure would be on top of Medicaid cuts, tariffs and the overall rising costs of goods and services. A 60-year-old couple earning $80,000 would see their annual health insurance premiums increase by over $12,000 if the credits aren’t extended, she said.
The people pushed off Medicaid because of massive funding cuts to that program would also skew younger, Lee said, and they may be left to choose between paying their rent or purchasing health care if the ACA credits are not extended.
When an insurance program loses its younger base, which tends to be healthier and therefore less expensive to insure, the base price of insurance gets costlier. The result is increased health insurance premiums for everyone, she said.
Lee warned about going back to the days when one-fifth of Nevadans were uninsured, which was the case as recently as 2013, according to U.S. Census Bureau data analyzed by America’s Health Rankings.
Nevada’s uninsured rate was 10.8% as of 2023, one of the worst in the country, according to the organization.
Lee attributed any looming crisis to Republicans, saying they are choosing to let the credits expire. “The money that they claim they’re going to save from doing this, they literally turned around to give handouts to the wealthiest Americans and bigger corporations,” Lee said, referencing the GOP-led One Big Beautiful Bill signed July 4.