Coalition urges Congress to protect vital insurance subsidies

Alabama Coalition Rings Alarm Bells over Potential Spike in Health Insurance Premiums

The Cover Alabama coalition, a non-partisan body comprising over 100 healthcare providers, businesses, and grassroots advocacy groups, has expressed concerns over the potential surge in Affordable Care Act (ACA) premiums expected next year.

The alliance, which aims to “advocate for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system,” is particularly worried about the impact of the upcoming expiration of certain federal tax credits in 2025.

Data indicates that nearly half a million Alabamians could experience a significant increase in health insurance costs if Congress does not extend the Enhanced Premium Tax Credits (ePTCs) beyond their expiry date. The ePTCs are federal subsidies for health insurance introduced by the “American Rescue Plan Act” and extended by the “Inflation Reduction Act.” They are distributed annually through the ACA’s Health Insurance Marketplace.

The Importance of ePTCs to Alabama Families

According to Cover Alabama, the ePTCs play a vital role in making health insurance affordable for families in Alabama. The coalition cites a report by the Kaiser Family Foundation, a non-profit specializing in U.S. healthcare policy research, which shows that 477,838 Alabamians enrolled in Health Insurance Marketplace plans in 2025.

The coalition also draws on a 2024 KFF study, which found that the average cost of Healthcare.gov premiums in Alabama would almost double, rising by an average of 93 percent, if the government does not extend the enhanced subsidies.

Moreover, the KFF found that ePTCs have reduced premium payments for ACA enrollees nationwide by an estimated 44 percent on average.

Implications of ePTC Expiration

Cover Alabama warns of the dire consequences of the expiration of ePTCs. According to a KFF report, combined with the effects of ACA Marketplace reforms laid out in the “One Big Beautiful Bill Act” passed in July, ePTC expiration would leave an extra 130,000 Alabamians uninsured by 2034.

Debbie Smith, Cover Alabama Campaign Director from Alabama Arise, asserted, “Without congressional action, families will face impossible choices between paying for health insurance or putting food on the table. These are small business owners, older adults, and working families who can’t absorb a hike in premiums. Congress has the power to prevent this crisis.”

Smith emphasized that the figures represent real people whose health could be compromised if insurance becomes unaffordable. “Without Medicaid expansion, Alabama already lags behind in coverage. Losing these tax credits would make a bad situation much worse,” she added.

Furthermore, the coalition referred to a study by the Commonwealth Fund which predicts that the cessation of ePTCs in 2025 could result in a loss of nearly 10,000 jobs in 2026 and a decrease in Alabama’s economic activity by $1.14 billion.

Call to Extend ePTCs

The coalition argued that Alabama, which has not expanded Medicaid to cover adults with low incomes, would be particularly impacted. “Hundreds of thousands of residents already fall into the ‘coverage gap,’ unable to afford private insurance but ineligible for Medicaid. The expiration of ePTCs would leave even fewer options for affordable coverage,” Cover Alabama stated.

As a result, Cover Alabama is encouraging residents to reach out to their members of Congress, urging them to secure the extension of ePTCs. It is also inviting people to sign a petition advocating for the continuation of the program.