Could your state be cutting health coverage? See if you’re affected
By
Aubrey Razon
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As the year ends, millions of Americans face a growing health security threat. Key benefits from the Affordable Care Act (ACA) are set to expire soon, unless Congress steps in.
Find out what’s at risk—and which states could be hit hardest.
These tax credits have helped make health insurance more affordable by lowering premiums and expanding income eligibility.
Since their introduction, five million more Americans have enrolled in health insurance through the ACA marketplaces.
However, these benefits may be at risk of ending soon.
The Urban Institute's report paints a grim picture: without renewal of the PTCs, an estimated four million people could find themselves without insurance.
This would mark a significant step backward in the nation's health coverage landscape.
Some states stand to suffer more than others, with the Sun Belt region facing the harshest blow.

Mississippi could see a staggering 43% increase in uninsured citizens, while Tennessee is not far behind with a projected 39% rise.
Alabama and South Carolina could experience a 34% increase in uninsured individuals, and Georgia and Louisiana are looking at a 32% jump.
These numbers are more than just statistics—they represent real people facing the prospect of being without essential health coverage.
You can access the interactive tool here created by the Urban Institute to explore the impact on health insurance coverage by state, age, income, race, and ethnicity.
It appears that the states facing the most significant challenges are those that did not expand Medicaid eligibility, with the exception of Alabama.
In these states, nearly 2.5 million people could lose their insurance, translating to a 27% increase in the uninsured rate.
The demographic most at risk is the 19 to 34 age group, who have been the primary beneficiaries of the PTCs.
In Mississippi alone, an additional 49,000 people in this age bracket could lose their insurance, with Tennessee facing a loss of 96,000.
Children are not immune to this crisis either, with thousands at risk of becoming uninsured in these states.
The future of the PTCs depends on Congressional action, with Republicans currently in control.
While Trump has since expressed a desire to improve the ACA rather than eliminate it, the future of the PTCs remains uncertain.
Have you or someone you know benefited from the Enhanced Premium Tax Credits (PTCs)? Are you concerned about the potential loss of health coverage in your state? Share your thoughts and experiences with us.
Find out what’s at risk—and which states could be hit hardest.
The uncertain future of health insurance subsidies
The Enhanced Premium Tax Credits (PTCs), introduced by the Biden Administration in March 2021, have been a lifeline for many.These tax credits have helped make health insurance more affordable by lowering premiums and expanding income eligibility.
Since their introduction, five million more Americans have enrolled in health insurance through the ACA marketplaces.
However, these benefits may be at risk of ending soon.
The Urban Institute's report paints a grim picture: without renewal of the PTCs, an estimated four million people could find themselves without insurance.
This would mark a significant step backward in the nation's health coverage landscape.
The states on the edge
The potential impact is not evenly distributed across the country.Some states stand to suffer more than others, with the Sun Belt region facing the harshest blow.

A report from the Urban Institute suggests that uninsurance rates nationwide could rise by 16%, with even higher rates in states mainly located in the Sun Belt. Image source: Urban Institute.
Mississippi could see a staggering 43% increase in uninsured citizens, while Tennessee is not far behind with a projected 39% rise.
Alabama and South Carolina could experience a 34% increase in uninsured individuals, and Georgia and Louisiana are looking at a 32% jump.
These numbers are more than just statistics—they represent real people facing the prospect of being without essential health coverage.
You can access the interactive tool here created by the Urban Institute to explore the impact on health insurance coverage by state, age, income, race, and ethnicity.
It appears that the states facing the most significant challenges are those that did not expand Medicaid eligibility, with the exception of Alabama.
In these states, nearly 2.5 million people could lose their insurance, translating to a 27% increase in the uninsured rate.
The demographic most at risk is the 19 to 34 age group, who have been the primary beneficiaries of the PTCs.
In Mississippi alone, an additional 49,000 people in this age bracket could lose their insurance, with Tennessee facing a loss of 96,000.
Children are not immune to this crisis either, with thousands at risk of becoming uninsured in these states.
The future of the PTCs depends on Congressional action, with Republicans currently in control.
While Trump has since expressed a desire to improve the ACA rather than eliminate it, the future of the PTCs remains uncertain.
Key Takeaways
- Millions of Americans are at risk of losing their health insurance if subsidies from the Affordable Care Act (ACA) are not renewed by Congress.
- The expiry of Enhanced Premium Tax Credits (PTCs) could lead to an additional four million people becoming uninsured, with a significant impact in states like Mississippi and Tennessee.
- The introduction of the tax credits under the Biden administration has led to an increase of five million people enrolling in health insurance through the Affordable Care Act.
- The Urban Institute report indicates uninsurance rates across the country could increase by 16%, with even higher rates in states concentrated around the Sun Belt.