John,

The Senate is expected to vote next week on an extension of the enhanced ACA premium tax credits that expire on December 31st. These credits are a lifeline for millions of people who need to access health insurance. According to the Centers for Medicare and Medicaid Services, not only did enrollment in Affordable Care Act plans increase by 13% from 2024, but 93% of enrollees were receiving a premium tax credit.¹

Without the these tax credits, insurance premiums will more than double starting January 1st.²

With only days left before the deadline to enroll in coverage for next year, Congress must act now to ensure that health insurance remains affordable for the more than 20 million people who receive their health care through the ACA marketplace. The Senate is voting next week on a clean extension of the expiring ACA tax credits,³ while the House only needs four more representatives to join a discharge petition and force a vote on the floor on their clean extension proposal.⁴

Send a message to Congress demanding that they extend the enhanced ACA premium tax credits and protect health care access for everyone.

People nationwide have been able to afford insurance because of the enhanced premium tax credits. A family of three with an income of about $40,000 pays no premium because of the current credits; if they expire, they will have to pay $1,675 a year, an extra cost they will find tough to afford.⁵ But for some people with very low incomes, these credits have been their only route to coverage. For example, ten states chose not to expand Medicaid coverage under the Affordable Care Act. In those states, people with low incomes who are denied Medicaid can get insurance premiums of $0 thanks to premium tax credits―and 6.2 million people have enrolled in those plans.⁶ That $0 premium goes away if Congress doesn’t extend the tax credits.

In addition to gutting Medicaid, Congress included a provision in last summer’s Big Brutal Bill that would strip access to the ACA tax credits for lawfully present immigrants with low incomes―an estimated 300,000 people, according to the Congressional Budget Office, who are not eligible for Medicaid.⁷ Congress must repeal this provision and extend the enhanced premium tax credits before they expire on December 31st.

By not extending these premium tax credits, Congress is inflicting unnecessary pain on millions of people and driving some to forego insurance altogether.

Send a message to Congress urging them to extend the enhanced ACA premium tax credits immediately.

Thank you for all you do,

Meredith Dodson
Senior Director of Public Policy, CHN Action

¹ Effectuated Enrollment: Early 2025 Snapshot and Full Year 2024 Average
² ACA Marketplace Premium Payments Would More than Double on Average Next Year if Enhanced Premium Tax Credits Expire
³ Senate Democrats eye vote on 3-year Obamacare subsidy extension
⁴ Discharge Petition No. 10
⁵The Struggle to Pay for Health Care and Food is Getting Worse
⁶ People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts
⁷ 300,000 Lawfully Present Immigrants Will Be Newly Ineligible for Health Care Help in This Open Enrollment Period

-- DEBORAH'S EMAIL --

John,

Last year, voters went to the polls with a very clear message: they want lower costs and better economic security.

Huge margins want the Affordable Care Act (ACA) enhanced premium tax credits extended, which have been keeping health insurance more affordable for tens of millions of people. A poll conducted a few weeks ago by a firm that has worked for President Trump found that 70% want the credits extended (only 20% do not).¹

Since last year’s election, Republicans have passed a budget that hands tax breaks to billionaires, but they refuse to renew tax credits that have been helping people afford health care. They’ve gutted basic needs programs like Medicaid and SNAP while families struggle to make ends meet. And now millions of people are at risk of going uninsured due to skyrocketing out-of-pocket costs.

The enhanced premium tax credits, which expire December 31st, have greatly expanded the number of people who can afford health insurance through the ACA marketplace, including offering $0 premiums on plans with decent health coverage for people living at or near the federal poverty line. Without those tax credits, that same plan will cost between $28 and $82 per month, plus co-pays.² $82 per month is almost $1,000 per year for a single adult earning as little as $23,475 annually. That’s tough to afford when rent, food, and heat swallow up most of your income. Without the enhanced tax credits, a family of three earning about $40,000 would go from paying no premium to an annual cost of $1,675. A 60-year old couple with an income of $85,000 would see their annual premiums skyrocket from $7,225 to $31,846.³

The Senate is expected to vote next week on extending enhanced ACA premium tax credits. 60 votes are needed. The House needs 218. They need to hear from us right now.

Send a direct message to your senators and representative telling them to extend the Affordable Care Act’s enhanced premium tax credits before it’s too late.

Republican leaders are pricing some people out of insurance and denying it altogether to others. Overall, an estimated 15 million are expected to lose health coverage in the coming years because of Republican policy priorities, including gutting Medicaid and the Affordable Care Act.⁴ The current changes to ACA eligibility by the Trump administration have disqualified an estimated 300,000 lawfully present immigrants with low incomes―including green card holders, DACA recipients, asylum-seekers, and immigrants with Temporary Protected Status―from accessing tax credits.^5,6

We need Congress to renew the current tax credits rather than come up with new guidelines that would reduce protections or health care coverage, as some proposals would do.

Join us in sending messages to Congress urging them to extend the enhanced ACA premium tax credits and make sure that everyday people, including legally present immigrants, don’t lose health care.

Deborah Weinstein
Executive Director, CHN Action

PS: I hope you’ll join us today, December 4 at 1pm ET, for our “Final Push to Extend the Health Care Tax Credits” webinar to discuss the strategy to get Congress to act, and what it means for tens of millions of Americans if they don’t. Click here to RSVP.

¹ NEW POLL: 86% of 2024 Voters Want New President and Congress to Extend Expiring Health Care Tax Credits
² Majority Bipartisan Support for Enhanced Premium Tax Credits - McLaughlin and Associates Poll, Nov. 10-11, 2025
³ People With Low Incomes May Lose $0 Premium Plans — a Lifeline — Unless Congress Acts
⁴ The Struggle to Pay for Health Care and Food is Getting Worse
⁵ By the Numbers: Harmful Republican Megabill Will Take Health Coverage Away From Millions of People and Raise Families’ Costs
⁶ 300,000 Lawfully Present Immigrants Will Be Newly Ineligible for Health Care Help in This Open Enrollment Period