John,

The threat to affordable health coverage is immediate and severe. In addition to the largest cuts to Medicaid in history, a recent letter from Senator Jeanne Shaheen and colleagues underscores that the Big Brutal Bill slashed over $1 trillion from health care including the ACA.

According to the letter:¹

“While Republicans in the House and Senate chose to extend nearly $4 trillion in tax cuts to benefit the ultra-wealthy and big corporations, they did not extend enhanced premium tax credits that almost 20 million middle-class and working Americans rely on. These expanded tax credits, which lower the cost of health care for individuals and families who use the ACA Marketplace, will expire at the end of the calendar year. Failure to extend these tax credits will cause premiums to skyrocket … beginning January 1, 2026.”

Americans cannot afford to face skyrocketing health care costs while the cost of living continues to outpace wages. Congress must fix this before it’s too late.

Send a message to Congress demanding they extend the ACA Premium Tax Credits as their first order of business when they return from August recess.

Senator Shaheen has reintroduced the Health Care Affordability Act to make these enhanced premium tax credits permanent.² She stresses that if credits are not extended early in 2025, insurers will proceed with the large rate increases they have already filed, making timely action essential. Altogether, as many as 20 million people across the country could face higher costs, with more than 4 million expected to lose their health insurance entirely.

From 2020, the year before the enhanced premium tax credits took effect, to 2025, the number of people with ACA marketplace insurance jumped from 11.4 million to 24.3 million, remarkable progress in making insurance available and affordable.³ But millions of people will suffer if Congress doesn’t act and extend or make permanent the ACA Premium Tax Credits when they return to session after their August recess. Health care is critical to economic security, and without those tax credits, people with ACA marketplace insurance will pay on average $700 more per year—making health care unaffordable for many.

It doesn’t have to be this way. Congress can act now to prevent millions more people from losing their health insurance by extending the credits and keeping health care premiums more affordable for all of us who have coverage from the ACA.

Send a message to Congress, telling them to protect our health care and extend the ACA Premium Tax Credits now.

Thank you for all you do,

Meredith Dodson
Senior Director of Public Policy, CHN Action

¹ Letter to Georgetown CHIR on marketplace_Final
² Shaheen, Baldwin, Underwood Seek to Lower Health Care Costs for Millions of Americans with Bicameral Legislation to Permanently Extend Affordable Care Act Premium Tax Credits
³ Enrollment Growth in the ACA Marketplaces

-- DEBORAH'S EMAIL --

John,

Health insurance companies just requested premium increases averaging 20% for 2026.¹ This is, in part, due to congressional Republicans’ refusal to extend the Affordable Care Act enhanced premium tax credit, which was keeping health care more affordable for millions of Americans.

Congress and the White House promised they would reduce health care costs for everyday people, but because Republicans chose to spend money on tax breaks for billionaires, rather than affordability for everyday people, the enhanced premium tax credit will expire at the end of this year. This will result in healthier people dropping their health insurance, while less healthy people remain. Sicker people means more costs to insurers. And it’s no surprise that they’re passing that cost along to the American people.

There’s still time to fix this when Congress comes back from their August recess.

Send a message to Congress and demand they restore the Affordable Care Act Premium Tax Credits and keep health care more affordable for everyday people.

Three hundred twelve health insurers participate in Healthcare.gov, the federally run ACA marketplace. 125 of them have requested premium increases higher than the average, ranging from 20% to 50% or more.²

Because the increased premium tax credits made insurance far more affordable, the number of people insured through the ACA marketplace jumped from 11.2 million in 2021 to 23.4 million in 2025. But if the enhanced premium tax credit is allowed to expire, the cost of marketplace insurance would be expected to rise by $700 per year.³ Payments for premiums would rise by over 75% on average, and in a dozen states, costs will more than double⁴—putting the cost of health insurance out of reach for many.

Access to health care is not a privilege; it’s a human right. Lacking health insurance leads to a host of adverse health outcomes that impact a person’s long-term health and livelihood. In the wealthiest country in the world, everyone should be able to get the health care they need.

Join us in calling on Congress to restore the ACA Enhanced Premium Tax Credits immediately.

Thank you for all you do,

Deborah Weinstein
Executive Director, CHN Action

¹ How much and why ACA Marketplace premiums are going up in 2026
²How much and why ACA Marketplace premiums are going up in 2026
³ An Updated County-Level Look at Imminent ACA Marketplace Premium Increases
⁴ How much and why ACA Marketplace premiums are going up in 2026