Ellen Allen: Capito signs away health care, calls it ‘freedom’ (Opinion)

By Ellen Allen
Originally published Dec 16, 2025 in the Charleston Gazette-Mail.

Earlier this month, Sen. Shelley Moore Capito, R-W.Va., dismissed the enhanced premium tax credits — the only reason 67,000 West Virginians can afford health insurance — as “waste.” Last week, she doubled down, voting for the Health Care Freedom for Patients Act, claiming it “lowers costs and puts patients first.” But West Virginians should look closely at what this bill actually does — and what it fails to do — because the gap between the rhetoric and the reality is enormous.

In her statement, Capito said Democrats were “sending billions of tax dollars to giant insurance companies without lowering premiums,” while her plan would “send money directly to Americans.” But that framing sidesteps the most critical fact: the enhanced ACA premium tax credits did lower premiums for West Virginians. They cut costs more deeply and more effectively than any other policy in a decade. And when they expire on Dec. 31 — because Congress let them expire — premiums in West Virginia will skyrocket overnight.

This is not theory. It is certainty.

The Capito-backed bill didn’t restore those tax credits. It called for replacing them with a patchwork of health savings accounts (HSAs) tied to bare-bones catastrophic plans that do not meet the needs of older adults, people with chronic illness, or families with ongoing medical costs. It directs funds into HSAs that millions of low- and moderate-income West Virginians cannot meaningfully use, because you need disposable income to benefit from an HSA in the first place.

Furthermore, the bill added an entirely unrelated list of restrictions targeting abortion, transgender people, and immigrants — none of which lower premiums for West Virginians or keep their families insured. At a moment when people in this state are bracing for crushing increases in health costs, the Capito-backed bill shifted attention to divisive cultural provisions instead of addressing the real crisis West Virginians are about to face.

Here’s the truth about what will happen on Jan. 1.

Premiums will explode. Families will see sudden increases of hundreds of dollars a month. Older adults — those hit hardest by premium spikes — could see thousands of dollars added to their yearly costs. For many, that will mean dropping coverage entirely.

This is not because West Virginians failed to plan or budget. It is because policymakers removed the only support making insurance remotely affordable in one of the sickest, poorest states in the country.

To call those supports “waste” is to trivialize the lived reality of West Virginians who already struggle to stay insured. It ignores the father taking half-doses of blood pressure medication, the grandmother stretching insulin, the young worker delaying a checkup because the deductible is too high. These are the people who depended on the enhanced tax credits that Congress chose not to extend.

Capito’s vote last week, framed as “putting patients first,” leaves those patients to face unaffordable premiums and lapses in care. The bill she voted for does not prevent that outcome. It does not replace the lost affordability. And it does not solve the very problem West Virginians are pleading for Congress to address.

What it would do is shift resources away from the mechanisms that kept rural families insured and instead promotes catastrophic plans that leave people exposed the moment they get sick. It also erected new barriers for already marginalized groups while offering no meaningful protection against the cost increases bearing down on this state. This is not a debate about partisanship. It’s about accountability.

The tax credits are ending because policymakers are choosing to end them. Premiums are rising because policymakers are dismantling the support that kept them down. Coverage will be lost because no meaningful replacement was enacted.

West Virginians deserve policymaking grounded in the realities of this state – not branding essential care as “waste,” not bills that prioritize political messaging over affordability, and not proposals that leave families shouldering impossible costs.

Because when Washington calls your health care expendable, it is not Washington that pays the price. It is West Virginia.

And beginning next month, every family that relies on marketplace coverage will feel the full force of that decision.