By Stacy M. Brown
Black Press USA Senior National Correspondent
Republican lawmakers are facing growing pressure from advocacy groups, constituents, and even some within their ranks to preserve critical healthcare tax credits under the Affordable Care Act (ACA), which are set to expire at the end of the year. But as the GOP weighs action, many appear more concerned about the political consequences of defying President Donald Trump—who continues to call for dismantling the ACA—than they are about the millions of Americans who stand to lose affordable coverage. Keep Americans Covered (KAC), a coalition of healthcare advocates has launched a sweeping seven-figure ad campaign targeting lawmakers in 12 states, including those represented by House Speaker Mike Johnson (R-LA) and Senate Republican Whip John Thune (R-SD). The effort features real Americans, including Jessica, a restaurant manager and cancer survivor from Arizona whose 10-year-old daughter lives with Type 1 diabetes. “We were living a perfectly normal life, and we suddenly had a child that had a chronic illness,” Jessica says in the ad. “We’re not wealthy. Money can get tight… we need Congress to take action now. It’s vital for us. We need these healthcare tax credits passed today”.
The ad comes as the Senate prepares to take up a tax bill passed by the House that would allow the ACA tax credits to lapse—putting more than 20 million Americans at risk of skyrocketing premiums or losing coverage altogether. According to a new analysis by the National Academy for State Health Policy, the expiration of the credits would hit family budgets hard. In North Carolina, a 64-year-old couple earning $82,800 would see their annual premiums rise by more than $18,000. A family of four in Florida earning $93,000 would face a 66% increase, or $ 61,920 more per year. “These aren’t hypothetical scenarios. They are real numbers for real people,” a KAC report warned. “The cost of doing nothing is real too. If this support is allowed to lapse, many families will be forced to make impossible choices: Do they pay their premium or their rent?” The consequences would also ripple through the economy. More than 4 million small business owners who purchase their coverage rely on these tax credits. Without them, many may have to slash jobs, halt expansion, or close entirely. “Small businesses are the backbone of our economy,” a KAC ad states. “But without affordable health coverage, many won’t survive. What will they cut to stay insured?” The political stakes are also mounting. A nationwide poll conducted for KAC shows that 72% of voters—including 63% of Republicans—support extending the tax credits. More than two-thirds of voters in battleground House districts said it is important to them that Congress act and nearly half said they would be less likely to support lawmakers who oppose the extension.
Despite this, partisan divides remain. Sen. Thom Tillis (R-N.C.), facing re-election in 2026, has called for a bipartisan solution. “We should start thinking about a stream of bipartisan bills that we can work on,” he said. However, others, such as Sen. Mike Rounds (R-S.D.), have echoed Trump’s criticisms of the ACA, claiming it contributes to the national deficit. “There’s been a facade out there about the entire program actually paying for itself,” Rounds said. Health policy leaders are warning that the timing is critical. Premiums for 2026 are already being finalized. “Congress can’t afford to wait until the last minute,” the KAC report states. “Coverage decisions are being made now. Families need clarity—and relief.” The coalition behind Keep Americans Covered includes AARP, cancer advocacy organizations, and national groups representing doctors, hospitals, and health insurers. They say the choice before Congress is clear: extend the tax credits or force working families, entrepreneurs, and the chronically ill into financial and medical crises. “The Senate and President Trump still have time to prevent this crisis,” KAC said in a recent statement. “But not much. They must act quickly to protect the marketplace, extend the health care tax credit, and support working people in America.”
