By Fred Redmond
This Saturday marks one month of the federal government shutdown. Hundreds of thousands of federal workers—nearly 20% of whom are Black and 30% of whom are veterans—are missing their second paycheck. Families across the country will be forced to choose between paying for groceries, rent and medical care. President Trump and his allies in Congress are inflicting this pain because they would rather shut down the government than deal with the looming health care crisis that will explode costs for more than 170 million Americans.
This is a crisis of the administration’s own making and was entirely avoidable. That’s because Trump and Congress are about to let a key funding program for the Affordable Care Act (ACA), the extended tax credits, expire. Without that funding source, out-of-pocket premiums will more than double for 22 million people—and 4.2 million people will be kicked off their coverage entirely.
Everyone will pay more for health care if the ACA tax credits disappear. As millions lose their coverage, hospitals and clinics will be forced to absorb billions in unpaid care costs, driving up premiums for all of us, whether you are covered through work or the ACA.
Combined with the Medicaid cuts that Republicans passed earlier this year, 179 million people with employer-based insurance could see their health care costs rise as much as $485 a year per person—or nearly $2,000 more a year for a family of four. Parents will be forced to put off checkups for their kids and people with chronic illnesses will face impossible decisions: refill their insulin or pay rent, start chemotherapy or pay the electric bill. One unexpected accident will leave a family unable to pay the mortgage or buy groceries.
For our community, a spike in health care costs isn’t just smoke—it’s a five-alarm fire. Since the implementation of the ACA, the number of Black folks without health insurance has been cut in half. In 2023, it reached an all-time low. That’s in large part thanks to the increased funding for the ACA passed in 2021, including the tax credits we’re fighting for today. But if they aren’t extended, we could see those gains almost completely reversed. Without the tax credits, Black Americans will see the largest increases in uninsurance rates—a 30% percent jump in those without coverage. One study estimates as many as 1.1 million Black Americans will lose coverage.
Even those who are able to hang on to their insurance will be forced to pay more if the tax credits aren’t extended. That funding passed in 2021 meant millions of working- and middle-class Black families with ACA coverage saw their premiums lowered or eliminated entirely. 76% of uninsured Black Americans were able to find a plan for less than $50 a month and 66% could find one entirely for free. But without the tax credits, those premiums could more than double. And those same families could be forced to pay hundreds—if not thousands—more every month.
Black working people are already struggling to pay our bills. Wages for Black workers are falling and our budgets are being squeezed by higher prices on everything from food and housing to electricity and gas. The Trump administration is offering no relief. The last thing we need is D.C. politicians hiking our health care costs.
The labor movement’s message to the president and his allies in Congress is simple: fix the health care crisis, fund the government and put working people first.
Fred Redmond, the highest-ranking African American labor official in history, is the secretary-treasurer of the AFL-CIO, the nation’s largest labor federation, representing 63 unions and nearly 15 million workers.
