Failing to extend the enhanced ACA premium tax credits is an attack on working-class Black families and major metro areas
S. E. Anderson
Failing to extend the enhanced ACA premium tax credits is an attack on working-class Black families and major metro areas
s. e. anderson
author of The Black Holocaust for Beginners
www.blackeducator.org
"If WORK was good for you, the rich would leave none for the poor." (Haiti)
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S. E. Anderson
Summary
Millions of working families will lose health care coverage, while millions of others are facing higher premiums, following the expiration of the enhanced Affordable Care Act (ACA) premium tax credits in January. Losing the subsidies will substantially reduce coverage for Black families in particular, as they are both more likely to live in states without Medicaid expansion and more likely to face uninsurance due to lower and less stable incomes. Our analysis projects Black losses in health care coverage attributable to the premium tax credits expiring for 10 major metro areas with large Black populations, along with the additional costs to those cities of said coverage losses, including: preventable Black deaths, increased annual premiums for remaining enrollees, increased costs to employers, lost worker productivity, and reduced local spending and economic activity. Acting to reinstate and extend the ACA premium tax credits is equity-enhancing, race-conscious economic and public health policy.
Families who lose insurance and families who remain covered both face significant new burdens, and the costs are substantial across the 10 metropolitan areas.
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- The number of Black residents without health insurance could increase by as much as 24% in major metro areas. The largest increases in Black uninsurance rates will be in the Atlanta, Dallas, and Houston metro areas.
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- The ACA credit expiration could lead to more than 200 preventable Black deaths each year. These deaths stem directly from the loss of affordable coverage and reduced access to timely care.
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- Black families could pay $740 million more in annual premium costs. Black families who are able to keep their health insurance would be squeezed by higher health care costs, further straining already tight household budgets.
- Local economies in major metros with large Black populations could lose more than $1.9 billion each year. Atlanta, Dallas, and Houston metros would lose the most economic activity as federal subsidies disappear and household spending contracts because families must redirect more of their income toward higher premiums and away from spending on local goods and services.