Preserve the ACA, Advance Tax Credits

Over the years, the West Virginia Council of Churches has been a strong proponent of the common good. As noted in its Public Policy Issue Priorities booklet: “As people of faith, we have long recognized that attention to the Common Good requires a reciprocal contract between people and society. People are social beings, not meant for uncaring isolation, but for loving relationships with each other and God. We must speak urgently about the Common Good because the pressing challenges of the day require real community if we are to find solutions.”

Surely, health care is at the top of the list, when it comes to those things that we can do together for the good of all. It is truly good news, then, that West Virginia is doing well making health care more accessible and affordable: Only 5.9% — approximately just over 100,000 — of West Virginians are uninsured, compared to over 8% nationally.

This would not have happened without the Affordable Care Act and Enhanced Premium TaxCredits. Prior to Medicaid Expansion under the ACA, more than 267,000 West Virginians went without access to health care. That is more than 2 1/2 times the rate of uninsured today. This is an extraordinary achievement, and it did not happen by accident or overnight.

The ACA improved access to health care for Americans in several ways, including:

• Expanding Medicaid, which is particularly important for West Virginians, as we have one of the highest poverty rates in the country.
• Improving access to preventive services by requiring insurers to cover recommended preventive services without additional cost sharing.
• Allowing young adults to stay on their parents’ plans until age 26.
• Requiring employers to offer health insurance for businesses with 50 or more full-time employees.
• Creating programs to improve the health of women and families.

It also is a main economic driver, especially in West Virginia, where rural hospitals, and urban alike, rely on Medicaid reimbursements as a major revenue stream.

Here at home, 47,900 West Virginians benefit from ePTC — saving the average enrollee an estimated $1,038 on monthly health insurance premiums in 2024. These tax credits are a lifeline for West Virginians who would otherwise not be able to afford their health coverage or access health care.

However, the advanced premium tax credits are set to expire after 2025. If Congress does not extend the tax credits, this assistance will be cut and tens of thousands of West Virginians will face losing their health insurance, delaying or skipping needed health care or taking on medical debt they cannot afford.

It is deeply concerning that either inaction regarding the enhanced premium tax credits or actions that would make health care unaffordable and inaccessible for more than 50 million Americans, including tens of thousands of West Virginians, could unfold in the coming year.

Maintaining access to affordable health insurance is crucial. We can never return to the days when West Virginians were denied health insurance coverage because they exceeded a lifetime limit or were denied coverage because they had a preexisting condition.