The state legislators, representing millions of people from Maine to Georgia to Michigan and other states, write in the new letter that Republicans in the US Congress are responsible for a "manufactured healthcare crisis" that's "particularly acute for younger Americans."
"Many are just beginning their careers, working in the gig economy, are self-employed, trying to start a small business, or are in positions requiring they purchase coverage on health care exchanges set up by the ACA," the lawmakers note. "Forcing them to go uninsured or pay exorbitant premiums could saddle them with medical debt that would haunt them for decades, stifling their ability to save, buy homes, and participate fully in our economy."
Among the 41 signatories of the letter, orchestrated by the advocacy group Defend America Action, are Maine House Speaker Ryan Fecteau (D-132) and Jeremy Moss (D-7), president pro tempore of the Michigan Senate. The letter is addressed to House Speaker Mike Johnson (R-La.) and Senate Majority Leader John Thune (R-S.D.).
"It is a cruel and calculated decision that prioritizes billionaires' tax breaks over the health and financial well-being of the American people you are supposed to serve."
Without the enhanced ACA tax credits, many younger enrollees—who are healthier on average—could decide to drop coverage altogether, potentially leading to a dreaded "death spiral" of premium increases across the board. The nonpartisan Congressional Budget Office has estimated that more than 4.2 million people would become uninsured if the enhanced ACA tax credits lapse.
"Let us be clear: This is a conscious choice on your part to rip away healthcare from the American people," the state legislators write. "Allowing these credits to expire will dismantle the progress we have made and plunge Americans into financial instability and uncertainty. It is a cruel and calculated decision that prioritizes billionaires' tax breaks over the health and financial well-being of the American people you are supposed to serve."
"The solution is straightforward, and the deadline is imminent," they added. "You must immediately pass a clean extension of the enhanced ACA tax credits before open enrollment begins on November 1, after which it will be too late. The health of millions is at stake."
The state legislators' demand adds to the pressure congressional Republicans are already facing from their constituents across the nation as the lawmakers refuse to negotiate with their Democratic counterparts, who are calling for an extension of the ACA subsidies as a necessary condition of any deal to end the government shutdown.
"As town halls fill with frustrated voters and no clear Republican plan emerges, the issue appears to be gaining political strength heading into next year's midterm elections," the Associated Press reported Tuesday. Recent polling indicates widespread, cross-partisan concern about premium hikes among likely US voters.
"It is painfully clear that Republicans are not listening to folks back at home," Sen. Patty Murray (D-Wash.) said during a press conference on Tuesday. "Because what families nationwide are saying is: 'Please stop my premiums from doubling.' And what Republican leaders are saying? 'Not our problem, we never wanted to lower healthcare costs in the first place.'"
On top of the profound health implications of skyrocketing premiums and large-scale insurance loss, an expiration of the ACA tax credits could do major damage to the US economy.
An analysis released earlier this month by the Commonwealth Fund estimated that nearly 340,000 jobs would be lost across the US next year if the subsidies lapse.
Georgia, one of the states represented in the new letter, would lose 33,600 jobs in 2026, more than any other state except for Texas and Florida.
