The Looming ACA Subsidy Crisis: What It Means for Black Communities
URGENT: ACA Subsidy Expiration Crisis Threatens Black Communities
Enhanced Affordable Care Act premium subsidies expired on January 1, 2026. For Black communities already facing disproportionate health challenges and economic barriers, this expiration threatens to unravel years of progress in expanding healthcare access.
The Numbers Tell the Story
Premium Increases Hit Hard:
- Average marketplace enrollees saw premiums more than double, from $888 to $1,904 annually—a 114% increase
- A 60-year-old couple earning $85,000 could pay $22,600 more per year
- Low-income families (150-200% of poverty level) face 400% premium increases
- Middle-income earners above 400% of federal poverty level lost ALL financial assistance
Coverage Loss:
- Up to 4 million Americans projected to lose health insurance in 2026
- Congressional Budget Office projects 3.8 million people without coverage annually from 2026-2034
- Communities of color, including Black Americans, will experience disproportionately higher uninsurance rates
Why Black Communities Are Most Vulnerable
Black Americans have been primary beneficiaries of enhanced ACA subsidies. Growth in marketplace enrollment concentrated among Black and Latino individuals, people with low incomes, and those in non-Medicaid expansion states. The expiration will:
- Widen Health Disparities: Black Americans face higher rates of diabetes, hypertension, and heart disease. Coverage loss means delayed care and worse outcomes.
- Create Impossible Choices: Families must choose between healthcare premiums and basic needs.
- Overwhelm Safety-Net Providers: Community clinics and hospitals face crushing burdens, potentially forcing closures.
- Trap Families in Coverage Gaps: In non-expansion states, families earn too much for Medicaid but can't afford unsubsidized premiums.
Political Reality: Despite urgent advocacy, the Senate rejected proposals to extend enhanced subsidies in December 2025. The political cost: $60 billion for two years, $350 billion for ten years. The human cost—measured in postponed cancer screenings, untreated chronic diseases, and preventable deaths—is incalculable.
What You Can Do
- Contact your Congressional representatives and demand action on ACA subsidy extension
- Share this report with your community and on social media
- Support local organizations fighting for healthcare access
- Educate yourself and others about marketplace enrollment options
- Vote for candidates committed to protecting healthcare access
About This Report
This analysis was prepared by the Baldwin Economic Justice Report to inform Black communities about critical threats to healthcare access and economic security. We are committed to providing accurate, actionable information that empowers our community to advocate for policy change.
