By Rev. Stacy Swimp
The enhanced health insurance subsidies, set to expire at the end of 2025, represent a direct threat to the financial and health stability of Black Americans. While the crisis affects all races, the consequences for the Black community will be disproportionate and severe, effectively rolling back historic progress in health equity. For this reason, targeted advocacy to Congressional representatives is an urgent necessity.
The disproportionate threat to Black America
The expiration is not colorblind; it targets the economic vulnerabilities historically faced by Black families.
1. Reversing historic coverage gains
The enhanced subsidies allowed Black Americans to achieve significant milestones in health security, which are now at risk:
- Massive enrollment: Black enrollment in the Marketplace grew by 95% from 2020 to 2023, a greater growth rate than every group except Latino consumers (ASPE, 2024). This means a large portion of the Black middle and working-class population is now directly vulnerable to losing financial assistance.
- Wider coverage gap: The expiration threatens to undo the progress that drove the uninsured rate for Black people under age 65 to its lowest point ever. Disproportionately large shares of Black people are covered through these Marketplace subsidies (KFF, 2025).
2. The crushing weight of the wealth gap
The sudden spike in premiums will hit Black families hardest because they lack the financial cushion to absorb the cost.
- Zero margin for error: The typical White household has over ten times the median net worth of the typical Black household ($250,400 vs. $27,100 in 2021) (Pew Research Center, 2023). When a premium doubles or triples, forcing a family to pay thousands of new dollars annually, the lower wealth of Black families means they are much more likely to be forced to drop coverage entirely.
- The “coverage gap” trap: A disproportionately high number of Black Americans live in states that have not expanded Medicaid (The Century Foundation, 2025). In these states, working-poor Black residents rely exclusively on the enhanced Marketplace subsidies. Their entire health security depends on Congress extending the program.
Why Black people must advocate now
The data makes it clear: the extension of the ACA subsidies is a fundamental issue of economic and racial justice for the Black community.
- Protecting safety-net providers: If millions of Black Americans lose coverage, the demand for uncompensated care will soar. This strains the community health centers and public hospitals that Black communities rely on most, threatening the quality and availability of care for everyone.
- Defining the narrative: The only way to ensure the subsidies are extended is by making it clear to elected officials that this is an existential threat to their Black constituents. Advocacy reframes the issue from abstract policy to a necessary step in protecting Black economic progress.
Call to zction: Making your voice heard
Black Americans must urgently contact their Congressional representatives—both in the House and Senate—and demand they support legislation to extend the enhanced ACA subsidies.
- Identify your representatives: Use online tools to find the names and phone numbers for your specific members of Congress.
- Call or email: Use the data above. State clearly: “I am a constituent and an advocate for the Black community. The expiration of the enhanced ACA subsidies will disproportionately harm Black families by reversing coverage gains and causing massive financial stress due to the wealth gap. I demand you vote to permanently extend these subsidies before the end of 2025.”
This is a defining moment to protect the progress made in the last decade. Our health and economic future depends on it!