Millions of Americans are at risk of losing their health insurance if Congress chooses not to renew subsidies from the Affordable Care Act.
Enhanced Premium Tax Credits (PTCs) are set to expire at the end of next year. If Congress does not renew them, an extra four million people would become uninsured, according to a report by the Urban Institute.
An additional five million people have enrolled in health insurance through PTCs since they were introduced by the Biden Administration in March 2021. The tax credits lowered premiums on insurance through the Affordable Care Act and raised income eligibility thresholds.
The future of the Affordable Care Act is uncertain with President-elect Donald Trump set to take office with a Republican controlled Congress—with many GOP lawmakers having been critical of the law.
Trump tried to repeal the Affordable Care Act during his first term. However, he wrote on Truth Social during the presidential campaign this year that he would not scrap the act if re-elected, but would make it "much better for far less money."
The Republican controlled Congress would have to vote to renew the Biden policy of PTCs next year.
If that does not happen, the states that could see the biggest increase in the number of uninsured citizens are Mississippi and Tennessee, according to the Urban Institute's report.
In Mississippi, an extra 43% more of citizens would become uninsured, while in Tennessee that figure would be 39%.
Across the country overall, Urban Institute's research estimates uninsurance would increase by 16%.
"The subsidies significantly reduce monthly costs for people purchasing plans through the ACA marketplaces," Michael Ryan, a finance expert and founder of michaelryanmoney.com, told Newsweek previously.
The worst affected states are all concentrated next to each other around the Sun Belt. The report projects that Alabama and South Carolina would experience a 34% increase in uninsured people, while Georgia and Louisiana would both see a 32% rise.
With the exception of Alabama, these are among the 10 states that did not expand Medicaid eligibility to more income brackets. Without PTC renewal, nearly 2.5 million people would lose health insurance across states without Medicaid expansion, translating into a 27% increase, according to the Urban Institute.
Currently, the age group most likely to be taking advantage of PTCs and therefore at the highest risk of losing insurance is those aged between 19 and 34.
An additional 49,000 people in this age group would lose insurance in Mississippi, along with 96,000 in Tennessee.
In Mississippi, 9,000 children would also become medically uninsured, along with 7,000 in Tennessee.
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