By Megan Sayles
AFRO Staff Writer
msayles@afro.com
The end appears near for the Affordable Care Act’s (ACA) enhanced subsidies. A last-ditch effort by Senate Democrats that would have extended the expanded assistance for three more years failed on Dec. 11, even as a small group of House Republicans joined Democrats in a move to force a vote on an extension.Though four GOP lawmakers signed a discharge petition to bypass House leadership, the measure will not reach the floor until January, as Congress has ended its session for the holidays.
With subsidies on track to expire Dec. 31, Medicaid recipients like 30-year-old Hillary Harris are bracing for the fallout.
(Photo courtesy of Hillary Harris)
Harris, a resident of Sikeston, Mo., said she’s relied on Medicaid for most of her life. A single mother, the coverage has helped her navigate pregnancy, postpartum depression and an ADHD diagnosis, while it’s afforded her daughter asthma and allergy medications.
“I’m concerned because, for instance, with my child’s asthma, her doctor and I noticed that she was coughing really bad all throughout the night, no matter the weather, when she was just using a cough medicine. This asthma inhaler that he gave her, which was Medicaid-covered, wiped that out completely,” said Harris. “Will I have to choose between an inhaler or cough syrup, or an inhaler or nasal spray when they’re working hand-in-hand?”
This kind of picking and choosing also raises alarm about Harris being able to obtain her ADHD medication, which she depends on to manage daily life and care for her 9-year-old.
“As far as my prescription, with cuts, that could provide delay. I am on what they consider a drug to where if I stopped taking it for three or four days, I experience withdrawal symptoms. I’m crashing, I’m not able to focus and I’m not able to work,” said Harris. “That concerns me because it’s not just me who’s on things like this. What about diabetics who have to choose between insulin or high blood pressure medication? What about the elderly who are hanging on for dear life to their heart monitors and they have to choose?”
A report from KFF, a nonpartisan health policy nonprofit, revealed that the average ACA Marketplace enrollee currently receiving a subsidy would see their annual premium payments more than double if the enhanced premium tax credits expire—rising from $888 in 2025 to an estimated $1,904 in 2026.
Health care advocacy organizations, like Families USA, have issued statements warning that such steep increases could force enrollees to forgo insurance entirely or move to lower-level plans with higher deductibles.
“As more people go uninsured or underinsured, they will delay necessary care, leading to worsening health conditions and putting more burden on expensive and overcrowded emergency rooms,” said Anthony Wright, executive director of Families USA, in a Dec. 11 statement. “Letting these tax credits expire will force over four million to lose coverage, millions more to pay thousands of dollars more and drive up costs for everyone.”
Harris, who referred to herself as a problem solver, noted that she’s already thinking about strategies for navigating these changes. She said she could try to space out her appointments or rely on emergency care if necessary. However, she emphasized that these are coping mechanisms rather than real solutions.
“If I’m having to choose between my Adderall and my child’s inhaler, as a mother I’m going to choose my child every time. If I have to choose between her therapy and my Adderall—because I know I have to show up as her mother—I’m going to choose my Adderall over her therapy,” said Harris. “But, all of these things go hand-in-hand with how we function and thrive, and it’s not fair for us to choose between one or the other because of cuts.”
Unlike Harris, Minneapolis mother Sam Gwesinie candidly told the AFRO that Medicaid was already her backup plan for affording health care. The 22-year-old has been on Medicaid since a psychiatric episode in high school required her to access care in a mental health facility that her prior insurance wouldn’t fully cover. Medicaid has since helped her manage her own mental health, support her autistic son and ensure her daughter can access developmental testing and routine care.
“If I’m being completely honest, I don’t have a plan in place,” said Gwesinie. “I just hope that our lawmakers and our representatives already have some type of plan or they’re working on something in the background for us because it would be frustrating to expect that responsibility to fall on people who are already struggling.”
Earlier this year, Gwesinie’s father temporarily added her back to his private insurance, and she said she struggled to afford co-pays and her $3,000 medications, half of which she had to pay out of pocket.
The experience made Gwesinie realize just how much she depends on Medicaid for herself and her children. She called on lawmakers to recognize the real-life impact of their decisions and to advocate for families like hers.
“See us, hear us, know that we are more than just numbers. We are real families. We need the programs that we get through Medicaid,” said Gwesinie. “Medicaid is so much more than just going to the doctor and not having a bill arrive in your mailbox. I’m a certified nursing assistant; Medicaid pays for my job. We elected our lawmakers for a reason, and we want them to stand up for us.”
