Today, Representatives Deborah Ross (NC-02), Valerie Foushee (NC-04), Alma Adams (NC-12), and Don Davis (NC-01) sent a letter demanding that Speaker Mike Johnson provide his plan to avoid a health care coverage crisis in North Carolina given the looming expiration of Affordable Care Act (ACA) enhanced premium tax credits (ePTCs). Congress has just over three weeks left to extend the credits that 888,000 North Carolinians rely on for affordable coverage before they expire at the end of the year. An estimated 157,000 North Carolina residents would be forced to give up coverage entirely if the credits expire, and hundreds of thousands more will face steep cost increases.

 

In the letter, the lawmakers emphasized the diversity of individuals and families in North Carolina using the credits, including farmers, small business owners, gig workers, and those who cannot obtain insurance through their employers. They also underscored the heightened risks facing rural North Carolina where the majority of marketplace enrollees reside and where hospitals and clinics already operate on thin margins. The lawmakers warned that steep premium hikes and coverage losses will lead to more uncompensated care in North Carolina, threaten the financial stability of rural hospitals, and worsen that state’s medical debt crisis.

 

“North Carolinians are already under severe strain from rising housing, food, and child care costs. They cannot absorb premium increases of 30 percent on the front end and 100 percent or more on the back end if the enhanced credits are allowed to lapse. They deserve stability and a functioning health insurance market, not a manufactured affordability crisis,” the Members wrote.

 

“The Congressional Budget Office has projected the [Big Ugly] law’s health provisions will increase the number of uninsured Americans by roughly 10 million by 2034, on top of the millions who will lose coverage when the credits lapse,” the Members continued.

 

The lawmakers requested that Speaker Johnson release his plan, asking:

• Whether he intends to allow a vote on bipartisan legislation to extend the ACA’s enhanced premium tax credits;
• If he opposes bringing an extension to the floor, what his plan is for the approximately 888,000 North Carolinians who currently rely on them to afford coverage as well as for the 157,000 state residents projected to become uninsured if they lapse;
• What steps he will take to mitigate the impact of the expiring credits on North Carolina’s rural communities; and,
• Whether he will commit to reversing or delaying the Big Ugly Law’s provisions that will further reduce health care access and affordability in North Carolina.

 

Full text of the letter is available here.