No one should have to skip a doctor’s visit or delay treatment because health insurance costs too much. But this fall, as open enrollment for Affordable Care Act (ACA) marketplace coverage begins on Nov. 1, millions of families, including tens of thousands here in Michigan, face the threat of soaring premium costs.

Unless Congress acts, the premium tax credit (PTC) enhancements that have made coverage more affordable will expire. These credits are the reason record numbers of Americans have health insurance today. Without them, premiums could increase by thousands of dollars for Michigan families who are already struggling to make ends meet due to rising costs for groceries, rent, and prescription drugs.

Headshot of a smiling woman wearing a green jacket against a dark beige background.
Monique Stanton is the president and CEO of the Michigan League for Public Policy. (Courtesy photo)

Consider this example: a 60-year-old Michigan couple earning $82,000 currently pays nearly $7,000 a year for a benchmark ACA plan. If Congress fails to extend the PTC enhancements, their annual premiums could jump to more than $20,591. That’s a crushing increase of nearly $14,000 for the same coverage.

The impact doesn’t stop there. Small business owners, self-employed workers and middle-income families across Michigan will face impossible choices. Some will be forced to drop coverage altogether. According to recent data, more than 76,000 Michiganders could lose health insurance because their premiums would simply be unaffordable if Congress lets these tax credits expire.

This crisis is not inevitable — it is the direct result of harmful decisions in the Republican “megabill,” which delivered permanent tax cuts to the wealthy while slashing Medicaid, cutting SNAP food assistance, and failing to extend the very credits that keep health insurance within reach. In other words, Washington chose to raise health care costs for millions of working families so it could hand out tax breaks to the wealthiest households.

That’s the wrong choice for Michigan. Families here don’t need more uncertainty or higher bills. The PTC enhancements have served as a shield, protecting 22 million Americans from skyrocketing premiums and making ACA marketplace coverage possible for people who otherwise couldn’t afford it. Taking that shield away now, just as insurance companies are hiking rates in response to new tariffs and red tape advanced in Washington, would put health care out of reach for thousands more Michiganders.

Families cannot afford half measures. They cannot wait another year while their premiums double or triple. Congress must deliver a lasting solution that guarantees health care remains affordable.

Here’s what lawmakers should do:

  • Permanently extend the premium tax credit enhancements so Michigan families don’t lose coverage or face unaffordable premiums.
  • Reverse cuts to Medicaid and SNAP, which are stripping away health and food security from the very people who need them most.
  • Prioritize people over the wealthy, ensuring that working families can afford their basic needs without sacrificing their health.

The stakes could not be higher. This is about whether a parent in Grand Rapids can afford both rent and health coverage. It’s about whether a child in Detroit can see a doctor when they’re sick. It’s about whether a small business owner in the UP can stay insured without going broke.

Affordable health care is not a luxury — it is a necessity. Congress must put Michigan families first, not tax breaks for corporations and the wealthy. Lawmakers should make the premium tax credit enhancements permanent and undo harmful cuts, ensuring that millions of Americans — including tens of thousands of Michiganders — can continue to rely on the health coverage they depend on.

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