UPDATE: Millions of Texans are bracing for a potential health insurance crisis as enhanced Affordable Care Act (ACA) tax credits are set to expire at the end of the year. If Congress fails to act by mid-December, Texas could see its already staggering uninsured rate—currently at 17%—rise sharply.
Officials report that the expiration of these critical subsidies threatens to undo significant progress made in recent years. In 2021, enhanced federal subsidies led to over 4 million Texans enrolling in marketplace plans, a surge that more than tripled enrollment figures. Now, local health care leaders are sounding the alarm, warning that without continued support, the number of uninsured Texans could jump by 27%.
“Texas is going to be hit the hardest out of any other state,” said Annie Spilman, executive director of Texans for Affordable Healthcare. She emphasized the ongoing health care cost crisis in Texas, exacerbated by the state’s choice to pursue a private-market health approach rather than expanding Medicaid.
According to Laura Dague, a Texas A&M University health policy professor, the loss of subsidies will worsen access issues, especially for vulnerable populations including small business owners, gig workers, and rural residents. The impact is expected to be widespread, affecting not just individuals but also local economies.
The Texas Hospital Association warns that increased costs of care will ripple through the system. “It increases the cost of providing care,” said Carrie Kroll, the association’s vice president of advocacy and public policy. Hospitals may struggle to remain financially viable, potentially leading to service cuts or closures, particularly in rural areas.
Research indicates that if subsidies are not extended, approximately 1.45 million Texans could drop out of the marketplace due to an anticipated average increase of 115% in out-of-pocket premiums. As fewer people enroll, costs for those remaining are expected to rise sharply.
As Congress reconvenes following a recent government shutdown, the fate of these tax credits remains uncertain. Republican lawmakers have signaled they will address the issue before the mid-December deadline. Local health care advocates stress that this is not a partisan issue but a critical health care concern affecting all Texans.
With the clock ticking, Texans are urged to stay informed and advocate for the extension of these vital tax credits. The potential fallout from their expiration could have dire consequences for the health of millions in the state.
For more information on how the premium changes could affect you, click here: KFF Calculator.
The urgency is palpable as Texas faces a defining moment in its health care landscape. The next few weeks will be crucial in determining the state’s direction in supporting its residents’ health needs.
