The Threat to Black and Hispanic Communities if Congress Lets Enhanced Premium Tax Credits Expire
What’s At Stake
The potential expiration of the Enhanced Premium Tax Credits (PTCs) would mark one of the largest health coverage losses in a decade — reversing gains made under the Affordable Care Act (ACA) and deepening inequities in both health and economic security.
These tax credits lower the cost of health care for more than 24 million people including family caregivers, small business owners, freelancers and gig workers, and people ages 50-64 years old who don’t yet qualify for Medicare. If Congress fails to act, premiums could rise by up to 75%, and over 4 million people could lose coverage altogether. The impact will fall hardest on Black and Hispanic families, who already face systemic barriers to care and disproportionate rates of medical debt.
If Congress fails to act, premiums could rise by up to 75 percent, and nearly 4 million people could lose coverage altogether. The impact will fall hardest on Black and Hispanic families, who already face systemic barriers to care and disproportionate rates of medical debt.
By The Numbers
- 56% of Black adults and 50% of Hispanic adults carry medical debt — the highest rates in the nation.
- 1.8 million Black and Hispanic people could lose coverage without PTCs.
- 75% potential spike in Marketplace premiums.
A Bad Situation About to Get Worse
The loss of enhanced premium tax credits would come on the heels of historic health care cuts in H.R. 1 — the so-called “Big Beautiful Bill.” Those cuts already slashed Medicaid funding, threatened hospital closures, and pushed more people into debt. Furthermore, H.R. 1 also terminated tax credits for large groups of lawfully present immigrants, including refugees, asylees, survivors of trafficking or domestic violence, and individuals on work visas. Allowing premium tax credits to expire would compound that harm, pulling away another lifeline from families already struggling to stay covered.
As coverage erodes, predatory financial products are waiting to fill the gap. From deferred interest credit cards marketed for medical bills to high interest installment plans, these traps prey on families of color locked out of affordable options—turning illness into long-term debt and instability.
What’s at Stake
- Skyrocketing Premiums: Families could face hundreds more out-of-pocket costs each month, forcing many to drop health coverage altogether.
- More Medical Debt: Coverage losses will deepen a crisis already concentrated in Black and Hispanic communities.
- Hospital Strain: Safety net hospitals in Black and Hispanic neighborhoods will absorb more uncompensated care, pushing them toward closure.
- Economic Fallout: Lost coverage means lost economic security—missed work, mounting debt, and widening racial wealth gaps.
The Human Impact
Without these tax credits, I wouldn’t be able to afford insurance or the care that keeps me healthy and able to work. These credits aren’t just financial—they’re what keep me alive.
Why It Matters Now
This isn’t just about premiums—it’s about power, equity, and priorities. Congress can choose to protect families and strengthen communities or allow another policy failure that hits Black and Hispanic families first and hardest.
To build a health system rooted in equity—not profit—Congress must act now to make Enhanced Premium Tax Credits permanent.
If you or someone you care for would be impacted by a spike in health insurance premiums, sign our petition and share your story here.
To speak with someone impacted by a premium increase for a news piece, please reach out to Jack Cardinal, Deputy Director of Communications at jcardinal@communitycatalyst.org.