As notices go to consumers informing them of what the price will be without the effect of the Affordable Care Act’s enhanced tax credits, Americans are experiencing sticker shock.
For those with disabilities, it is a sticker shock that ripples through every other aspect of their life.
Will they be able to work, afford the health care that keeps them able to work and able to be as independent as possible?
It is imperative that Congress find a path forward to ensure the extension of the credits before they expire Dec. 31. South Carolinians have even less time given that many plans require a lock-in date of Dec. 15 to go into effect by Jan. 1.
For example, one 38-year-old disabled veteran in South Carolina has a spinal cord injury and post-traumatic stress disorder and uses the Veterans Affairs health care system for care. However, the specialists he needs are over an hour away, so he also relies on a plan in the federal online marketplace to see local providers.
In 2025, this veteran’s private health insurance plan cost $96 a month and covered his local doctor, therapist, and the only nearby physical therapist trained in spinal cord injuries.
Should the expanded tax credits go away, this veteran’s premium jumps to $421 a month — a 339% increase — due to higher rehab and equipment costs, fewer insurers in his area, the loss of certain subsidy protections, and rising demand for mental-health and chronic-care services.
The new premium alone would take about 20% of his monthly income, forcing him to choose between rent, food, and care. He would begin skipping therapy and delaying appointments, relying more on the distant Veterans Affairs doctors even though travel is painful and difficult.
Republicans in Congress have long championed policies that strengthen families, promote work, and lift barriers to independence, including the Americans with Disabilities Act.
One of the most effective ways to uphold those principles is by extending the Affordable Care Act premium tax credits quickly before the uncertainty raised by the lack of the credits forces people to make choices that undermine their health and ability to be as independent as possible.
Without affordable health insurance, medical debt will rise, severely impacting those who already have higher out-of-pocket costs for medications, medical equipment and other services.
The credits in place now help reduce uncompensated care, preventing cost-shifting onto taxpayers. They assist in the stability of the insurance marketplaces.
Without the tax credits and affordable health insurance, the options for individuals with disabilities are often to rely on public programs or to go without insurance.
Unfortunately, whatever the flaws of the status quo, relying on public programs or simply going without will only increase federal spending on health services through increasing public program costs or spending on uncompensated care and treating individuals when they are sicker and more expensive.
Dec. 31 is just two weeks away.
Kimberly Tissot is a nationally recognized disability rights leader and president and CEO of Able South Carolina The disability-led organization seeks transformational statewide changes grounded in the philosophy “nothing about us without us.” She lives in York County.
