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Enhanced premium tax credits are set to expire at the end of 2025, imperiling tens or hundreds of thousands of contractors.Sue Dorfman\/Zuma<\/p>\n
\t\t\t\tGet your news from a source that\u2019s not owned and controlled by oligarchs. Sign up for the free Mother Jones Daily.<\/a><\/p>\n Comedian Megan Sass has been struggling to get their health insurer to cover intravenous immunoglobulin for more than a year. The treatment, which addresses a genetic antibody deficiency<\/a>, requires antibodies from blood donors. Without insurance, it\u2019s unaffordable. And with the looming expiration of Affordable Care Act subsidies, Sass\u2019 insurance will soon cost $1,300 a month.<\/p>\n \u201cI am not at a place where I\u2019m been able to joke about this,\u201d they said.<\/p>\n ACA marketplace subsidies, first implemented in 2014, expanded greatly during the Biden administration, allowing millions more people to afford private health insurance. But enhanced premium tax credits are set to expire at the end of 2025. As ACA architect Jeanne M. Lambrew told me in October<\/a>:<\/p>\n When the Biden administration came in during the pandemic, they tweaked the premium tax credits to improve them, which doubled enrollment. It increased the racial diversity of enrollment. It increased [the number of] low-income people enrolled. It removed a cliff, so when people\u2019s income increased, they didn\u2019t like fall off and have nothing. All that led to great gains and all that is at risk.<\/p>\n<\/blockquote>\n For contractors and freelancers in particular, the expiration of these enhanced subsidies could decide whether or not they can afford health insurance. According to KFF<\/a>, around half of adults who purchase ACA marketplace plans are self-employed, small business owners, or their employees. Disabled people who work are 50 percent<\/a> more likely to be self-employed than non-disabled people, meaning that people with existing health issues are at disproportionate risk of losing private health insurance for affordability reasons. <\/p>\n The ACA offers disabled people \u201coptions that many other people take for granted,\u201d said Mia Ives-Rublee, senior director of the Center for American Progress\u2019 Disability Justice Initiative, especially given the ties between insurance and employment.<\/p>\n The situation is especially frustrating for chronically ill and disabled contractors who watched Democratic leadership in Congress abandon a shutdown meant to protect those subsidies; President Donald Trump, during Thanksgiving week, then backtracked<\/a> on a supposed plan to extend the tax credits when faced with the displeasure of congressional Republicans.<\/p>\n\n