Democrats seek extension of expiring health care subsidies

Joe Dodson

WASHINGTON (CN) — When Virginia-based small business owner Laura Packard was diagnosed with stage 4 cancer, she relied on the Affordable Care Act marketplace to pay for her chemotherapy.

“The Affordable Care Act saved my life,” Packard said during a press conference Monday. “I am one of the millions of Americans that is terrified of opening the mailbox and getting the sheet of paper that will say what my premiums will be next year.”

Virginia congressional Democrats Bobby Scott, Jennifer McClellan, Don Beyer, Suhas Subramanyam and newly elected James Walkinshaw joined Packard in advocating for a permanent extension of enhanced premium tax credits.

“As a cancer survivor, I have to pay it. I cannot go without health insurance,” Packard said. “Lives are at stake.”

Congress expanded the refundable tax credit, designed to help eligible individuals and families with low or moderate incomes afford health insurance through the health insurance marketplace, in 2021 as part of the American Rescue Plan Act. Lawmakers extended it through 2025 as part of the Inflation Reduction Act. The credits are set to expire at the end of the year.

The expanded form of credits is available to higher-income taxpayers who rely on marketplace plans. The expansion allowed those whose household income is above 400% of the federal poverty line to claim credits for the tax years 2021 through 2025.

Research firm KFF predicts that without the credits, premiums could rise by a median of 18% in 2026. Over 40 million Americans have health insurance through the Affordable Care Act, with over 24 million Americans enrolling in the health insurance marketplace during the 2025 open enrollment.

Advocates worry healthy plan members will leave the marketplace when their premiums increase, while those most in need of health care will be left to pay increased underlying premiums.

“Those that are sick will pay the higher prices. Those that are healthy might drop out,” Scott said. “The insurance pool will be sicker and they’ll have to charge higher prices.”

Walkinshaw emphasized that allowing the credits to expire will stifle entrepreneurship, as more potential small business owners will worry about how they will pay for health care.

“It’s the existence of the exchanges and the affordability of the insurance on the exchanges that has allowed them to take that leap to start a business,” Walkinshaw said. “If you take away affordable health care on the exchanges, millions of Americans who would like to start their own business will no longer be able to do it.”

Lester Johnson, a Richmond-based restaurant owner, said he relies on the credits to maintain his health. Johnson noted that without the credits, his premiums will double.

“Restaurants operate on very slim margins, and most owners don’t get rich in this business. We do it because we are passionate about preparing food and creating a space for our community,” Johnson said. “Having access to good health care gives my employees and I the peace of mind we need to focus on the work we love.”

Republican and fellow Virginian Representative Jen Kiggans introduced a bill to delay the expiration until 2027. The bill has 12 Republican co-sponsors and eight Democrats.

“As a nurse practitioner, military spouse, and Mom, I understand firsthand how critical affordable health care is for working families,” Kiggans said in a press release. “In Congress, I’ve made it my mission to ensure Virginians—especially our seniors, small business owners, and middle-class families—aren’t blindsided by skyrocketing costs they can’t afford. While the enhanced premium tax credit created during the pandemic was meant to be temporary, we should not let it expire without a plan in place. My legislation will protect hardworking Virginians from facing health insurance bills they can’t afford, thus losing much-needed access to care.”

Virginia Democrats, none of whom are co-sponsors, criticized the bipartisan effort. Scott said Kiggans and the other Republicans, who happen to reside in competitive districts, are only focused on appeasing voters in 2026.

“To postpone the pain until after the midterms does not solve the problem,” Scott said. “It just protects people from the immediate aftermath of inflicting this damage on the American people."

McClellan said the extension should be permanent.

“A year is just not enough,” McClellan said. “This constant kicking the can down the road just puts that much more stress on people, families and particularly small businesses."

The press call comes after the Democrats in the Senate shot down a House-backed stopgap budget on Sept. 19 that would keep the government funded through November. Senate Democrats hope to pass an alternative continuing resolution that would extend the subsidies and walk back Medicaid cuts.

The topic hits close to home as WHSV reported in early September that Augusta Medical Group, serving the Shenandoah Valley, would close three of its rural health care facilities in response to the federal legislation dubbed the One Big Beautiful Bill, which will cut around $1 trillion in federal Medicaid spending over the next 10 years. Augusta Health’s president, Mary Mannix, told WHSV that around 70% of the patients they serve rely on Medicare or Medicaid.

“Premiums will go up for everyone,” Subramanyam said. “It’s only gonna make people sicker, it’s gonna make health care more expensive, and we have to do something now.”