Article Summary –
The potential expiration of Affordable Care Act tax credits in December poses significant challenges for Pennsylvania, with health insurance premiums expected to more than double for half a million residents and potentially 20 million nationwide, as Congress has yet to extend them. This situation could lead to increased reliance on emergency rooms due to a lack of preventative care, further burdening an already strained healthcare system dealing with Medicaid cuts and hospital closures, with 25 rural hospitals in Pennsylvania at risk. Nurses, who are already facing burnout and staff shortages, fear the increased workload and stress, and are advocating for Congress to extend the tax credits to prevent these adverse outcomes.
The expiration of Affordable Care Act (ACA) tax credits, crucial for Americans purchasing healthcare through state marketplaces, threatens Pennsylvania’s healthcare system and intensifies nurse fatigue due to existing staffing shortages, according to registered nurse Peggy Malone.
Half a million Pennsylvanians and 20 million nationally may see premiums double in 2026, as congressional Republicans have yet to extend the ACA tax credits, set to expire in December. These credits, implemented during the 2021 COVID-19 employment crisis, are crucial.
Millions risk losing coverage if Congress lets these credits expire, notes the Center on Budget and Policy Priorities. “It’s possible they’ll lapse,” said Malone, a 37-year veteran nurse and executive board member of Pennsylvania’s nurses union, emphasizing the potential devastation.
Without ACA tax credits, Pennsylvanians might skip preventative care, opting for emergency rooms for untreated issues, Malone warns. After losing her job at Crozer-Chester Medical Center, now closed, she works per diem at Jeffrey Einstein Philadelphia Hospital.
“People will delay doctor visits,” Malone said. “They’ll end up in overcrowded emergency rooms.”
Medicaid cuts add stress, as Republicans slashed $1 trillion in their One Big Beautiful Bill Act, signed by President Trump, risking closure for 25 rural hospitals in Pennsylvania, states Gov. Josh Shapiro.
“Hospitals serving underprivileged communities, heavily reliant on Medicaid, face closures,” Malone explains. “We already see maternity and behavioral health departments closing.”
Nurses, already grappling with burnout and staffing woes, will face more pressure with a possible nursing exodus, Malone said.
“Nurses are retiring early due to stress,” she said. “We face COVID-like conditions, working longer hours with sicker patients.”
Many nurses feel they’re at a breaking point even before ACA or Medicaid coverage losses, Malone noted.
“Nurses cry in their cars post-shift,” Malone said. “We’re not yet seeing the full impact.”
In the final stretch for ACA tax credits, Malone hopes for congressional action. Recently, the Republican-led Senate failed to advance credit extensions. On Dec. 17, four House Republicans joined Democrats in a discharge petition for a three-year extension, including Pennsylvania Reps. Brian Fitzpatrick and Rob Bresnahan. A vote isn’t required until January, post-expiration. Lawmakers urge House Speaker Mike Johnson for an immediate vote.
“They must prioritize constituents and the human impact,” Malone urged.
—
Read More Pennsylvania News
