Union members deliver letter to Fetterman's office

The Fight for Affordable Care Act Tax Credits Intensifies

As the threat of a government shutdown looms, the battle over extending the Affordable Care Act (ACA) tax credits has become a critical issue for low-income workers across the United States. In Pennsylvania, the Service Employees International Union (SEIU) has taken a proactive stance by organizing health care workers in Harrisburg to deliver letters to U.S. Senators John Fetterman and Dave McCormick. Their message is clear: preserve the ACA tax credits to ensure continued access to affordable health care.

Congressional Republicans have proposed a continuing resolution bill that would fund the federal government through 2026 but does not include the extension of the ACA tax credits. This move has put Democrats in a difficult position, as they had previously insisted on the extension as a non-negotiable condition. Without compromise, the government faces a potential shutdown after the September 30 deadline, an outcome that Senator Fetterman has strongly opposed.

“I enthusiastically support extending the ACA tax credits,” Fetterman wrote on X. “I’ll never vote to shut our government down over that or any reason. It’s a core responsibility of Congress to maintain a functioning government, and I refuse to hold it as hostage.”

While SEIU members do not take a position on whether the government should be shut down, they emphasize the need for Fetterman to advocate for the 300,000 Pennsylvanians who could lose their health care coverage if the credits lapse. Kathy Caber, the senator's constituent services director, met with union workers at his Harrisburg office and affirmed that Fetterman supports the extension of the credits.

“The government has shut down less than a dozen times, most recently under President Donald Trump for 35 days between 2018 and 2019,” said Caber. “The result is hundreds of thousands of furloughed federal employees, the slowing or stopping of a broad stretch of work, and usually huge costs to the government itself.”

For home care workers like Lynn Weidner, the stakes are personal. She relies on the ACA tax credits to afford her insurance, which costs $450 per month. With a minimum wage job paying $14 per hour, she faces a potential 82% increase in premiums if the credits are not extended. Weidner also struggles with rising housing costs, as her rent increases by $100 each year while her income remains stagnant.

“My housing is going up, too. Every year, my rent goes up by $100, but my income doesn’t go up. I don’t get raises every year, so at some point I’m going to get priced out of my apartment,” she said. “I am going to have to choose between my health and my housing, and it’s not fair.”

Home care workers like Weidner face limited opportunities for higher pay, as the state’s Medicaid reimbursement rates for their services are among the lowest in the region. While Governor Josh Shapiro’s budget proposal includes an additional $21 million for the industry, advocates argue that this amount is insufficient to meet the cost of living.

The implications of losing the ACA tax credits extend beyond individual workers. Health care professionals warn that the loss could have catastrophic effects on the entire industry, impacting both those with private insurance and those relying on public programs. Hospitals and clinicians depend on Medicaid revenue to stay operational, and critics say the state’s low reimbursement rates strain the system.

If more people become uninsured, the rate of uncompensated care—when hospitals provide services without payment—will likely rise. To remain viable, hospitals may be forced to cut costs or raise prices, leading to issues such as maternity care deserts and soaring health care costs.

Doctors also highlight the risks of inadequate insurance coverage. Patients without proper insurance are less likely to seek preventative care, often resulting in emergency room visits for more severe and costly conditions. A home care worker expressed concern about patients ending up in nursing homes with low staff ratios and long waiting lists, while a hospital worker worried about the elderly who have paid into the system throughout their lives.

“Every individual deserves the right to live independently,” said home care worker Helen Burke. “My consumers work. They pay taxes to the state. Damn it, you guys need to make sure those taxes are still being used for them.”

A recent KFF poll found that 77% of Americans support extending the ACA tax credits, highlighting the widespread recognition of the importance of these protections. As the debate continues, the voices of low-income workers and health care professionals remain central to the conversation, emphasizing the need for a solution that ensures access to affordable and comprehensive health care for all.