Congressional Battles Over ACA Subsidies Threaten Healthcare Access for Marginalized Communities

U.S. lawmakers and advocacy groups warn that the expiration of ACA tax credits threatens the health and well-being of marginalized populations
Oct. 22, 2025
5 min read

Key Highlights

  • Lawmakers and advocacy groups are warning that the expiration of ACA tax credits will disproportionately harm communities of color by increasing insurance premiums and reducing access to care.
  • The debate centers on extending subsidies to prevent a rise in healthcare costs, with Democrats emphasizing the life-saving benefits of the ACA and Republicans pushing for budget cuts.
  • Community leaders highlight that marginalized groups, including Black, Latino, and Asian Americans, are most vulnerable to policy shifts that threaten healthcare access and affordability.
  • Recent surveys show that voters prioritize healthcare costs over other issues, underscoring the importance of protecting ACA benefits for all Americans.
  • Advocates call for bipartisan action to safeguard healthcare programs, emphasizing that policy decisions now will have lasting impacts on health equity and community well-being.

On Tuesday, October 21, U.S. Representatives Grace Meng (D-NY), Glenn Ivey (D-MD), Darren Soto (D-FL), Jill Tokuda (D-HI), Nikema Williams (D-GA), and Nydia Velázquez (D-NY) joined health advocacy organization Protect Our Care, along with other advocacy groups and leading civil rights organizations, to highlight the effects of the looming healthcare crisis on communities of color.

A major sticking point in negotiations over the current budget bill, which caused an impasse leading to the Government shutdown, was Democrats' demand to extend tax credits and subsidies for Americans getting health insurance through the Affordable Care Act (ACA) marketplace exchanges, and Republicans' demand to end that kind of financial support.

In the last few months, Healthcare Innovation has extensively covered the issue of healthcare subsidies expiring on December 31 if Congress takes no further action. Healthcare advocacy groups have repeatedly warned of the effects on families when the ACA tax credits expire. Furthermore, advocacy groups cautioned that communities of color will disproportionately feel the effects of the resulting rise in health insurance premiums.

During Tuesday’s press call, Shavon Arline-Bradley, president and CEO of the National Council of Negro Women, cautioned that “these are real-life American realities that will affect Black women and their families.”

Protect Our Care Policy and Health Equity senior advisor Joi Chaney agreed, “They are targeting people and families of all races, and we know that any time everyone is targeted, communities of color feel it first. They are the canaries in the mine and must never be forgotten.”

Indeed, “the expiration of Affordable Care Act tax credits and looming Medicaid and Medicare cuts are not just policy shifts—they are a direct threat to the health and well-being of Black Americans,” said Marc H. Morial, president and CEO of the National Urban League.

Thanks to the ACA’s enhanced premium tax credits, “people of color have made significant gains,” noted Deborah Weinstein, executive director of the Coalition on Human Needs. “If Congressional leaders and President Trump refuse to extend the expanded Premium Tax Credit, we will see an entirely needless and dangerous step backward.”

“For the Latino community, the stakes could not be higher,” said Janet Murguía, president and CEO of UnidosUS. “It is Congress’s responsibility to make sure that any funding package protects access to and the affordability of healthcare, places clear guardrails on abusive and unconstitutional immigration actions, and preserves the rights of all Americans.”

“The current administration’s policies will lead to more suffering for our Black and Latino communities,” Annelys Roque Gardner, an infectious disease doctor, added. “Care will be delayed, and people will die. This doesn’t have to happen.”

"President Trump and Congressional Republicans are once again attacking our healthcare and our communities,” said Rep. Grace Meng, Chair of the Congressional Asian Pacific American Caucus (CAPAC). “They are single-handedly responsible for the largest cut to Medicaid in U.S. history – a lifeline for 4.5 million Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) – and are now raising premiums for over 1.5 million AANHPIs.”

“This is a transfer of wealth from the needy to the greedy that’s never been paralleled in American history, and I think it’s critical for us to do everything we can to stop it,” said Rep. Glenn Ivey.

“We clearly know what our red line in the sand is, and that’s saving people’s lives, it’s healthcare,” shared Rep. Jill Tokuda. “When I look at my AANHPI community, the bottom line is we’re surviving, we’re thriving, we’re living longer thanks to the Affordable Care Act. When we talk about permanently extending Affordable Care Act premium tax credits, this is about saving lives.”

“Right now, working families in Georgia’s fighting fifth district are having tough kitchen table conversations,” noted Rep. Nikema Williams. “They’re looking ahead to open enrollment, wondering if Republicans are going to double or even triple their premiums.”

Rep. Nydia Velázquez alerted, “Donald Trump and Congressional Republicans have launched an unrelenting assault on the nation’s healthcare system.” She highlighted that “more than half of Hispanics say that because of costs, they either didn’t fill a prescription, skipped a follow-up test, or avoided going to the doctor altogether when they were sick.”

“A government that cannot protect its people’s basic well-being has failed its most fundamental test,” said Derrick Johnson, president and CEO of NAACP. “This is policy violence against Black people and the 24 million Americans who rely on the ACA marketplace for healthcare.”

Anthony Wright with Families USA reminded the audience that the premium increases are not inevitable, stating that “these spikes in healthcare costs are a policy choice by Congress and the Trump Administration.”

“Let's come together,” opted Rep. Darren Soto. “Let’s save America’s healthcare.”

Meanwhile, a new survey by Families USA revealed that voters are much more concerned about healthcare costs, such as health insurance premiums, than any other issue, including housing, crime, and immigration, as our editor-in-chief, Mark Hagland, reported.

About the Author

Pietje Kobus

Pietje Kobus

Pietje Kobus has an international background and experience in content management and editing. She studied journalism in the Netherlands and Communications and Creative Nonfiction in the U.S. Pietje joined Healthcare Innovation in January 2024.

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