by Ellen Allen, West Virginia Watch
March 27, 2025

The Affordable Care Act (ACA) was signed into law 15 years ago, and it remains one of the most consequential health care reforms in our country’s history.

At the time it was enacted I was the CEO of Covenant House. We were the recipients of a small grant — awarded from West Virginians for Affordable Health Care, no less — that allowed us to act as Community Assisters. Covenant House advocates enrolled over 300 West Virginians  — some of our most vulnerable citizens — in health care; for most it was the first time in their lives that they had access to health insurance. 

Over the last 15 years, the ACA has expanded affordable coverage to people previously locked out of health insurance, lowered premiums and out-of-pocket costs, and helped the nation’s uninsured rate reach an all-time low. Unfortunately, dismantling it remains a top Republican priority as they look to give tax breaks to the ultra-wealthy and big corporations. 

Do we really want to make it nearly impossible for West Virginians to afford health care? 

The ACA protects 737,900 West Virginians with pre-existing conditions from being charged more or denied coverage by insurance companies. It guarantees free preventive care for over 217,000 West Virginians, and it allows young adults to stay on their parents’ insurance plans. More Americans than ever count on it today: a record 24.2 million Americans are enrolled in quality coverage thanks to Enhanced Premium Tax Credits (ePTC) that make health care more affordable for millions of middle-class families purchasing coverage on their own. 

Millions of Americans are relying on these tax credits, but Republicans want to take them away, which would lead premiums to spike and leave 5 million more people uninsured. 

I personally acquire my health care through the ACA and qualify for ePTC. I do pay my fair share: The ePTC makes health insurance more affordable for me. If the ePTC are not renewed, my combined out of pocket and annual premium costs would reach $40,000 annually. I’ll be honest, this makes my heart skip a beat. 

Unless Congress acts now, premium costs will skyrocket for over 64,000 families across West Virginia, including me. On average, families would pay at least $1,404 for their premiums, and 5,300 West Virginians will lose their insurance entirely — including people who are self-employed, small businesses, older adults who don’t yet qualify for Medicare, people living in high-cost rural areas, farmers, people with pre-existing conditions and more. 

Lower premium costs have helped take the pressure off families and given them more room to pay for other necessities like food, rent and gas. ACA coverage in West Virginia has more than doubled thanks to the efforts of Democrats who have worked tirelessly to protect and expand the ACA. 

Yet, here we are again, standing at the edge of a health care cliff. Republicans are pushing to raise premiums and health care costs for 24 million Americans by taking away these tax credits from hard working families. From day one, Republicans have been fighting to raise health care costs, from voting against these savings in the first place to now taking them away. 

Instead of protecting affordable coverage, Republicans are more focused on delivering tax breaks to billionaires and big corporations while leaving Mountaineers struggling to get by. Losing these savings would be devastating to millions who may otherwise not be able to access health care. As a result, millions of families will once again have to choose between being able to see a doctor or keeping a roof over their heads. 

As the ACA turns 15 years old this month, the law is unfortunately once again in Republicans’ crosshairs while Democrats have introduced the Health Care Affordability Act to ensure health care costs remain affordable for people who buy coverage on their own. If Republicans are serious about bringing down costs, they will ensure these tax credits remain available for families for years to come, and people with pre-existing conditions can continue to afford coverage. It is time for Republicans to get on board and protect the health care of millions of Americans.

West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.

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