Texas Faces Rising Uninsured Rates as ACA Tax Credits Set to Expire

The expiration of enhanced premium tax credits for Affordable Care Act (ACA) enrollees in Texas poses significant challenges for over 4.2 million people currently covered under ACA plans, with approximately 95% reliant on these subsidies to afford insurance. This tax credit reduction, tied to federal budget changes, will considerably increase premiums for many and potentially lead to higher uninsured rates in the state.

Healthcare providers, including hospitals in both urban and rural areas, anticipate an increase in uncompensated care as patients lose coverage and turn to emergency care services. Rural hospitals face heightened risks, with projections indicating up to 15 could close in Texas, intensifying pressure on metropolitan medical facilities. Local public health systems, such as Tarrant County's JPS Health Network, may absorb tens of millions in additional uncompensated care costs, creating financial strain across regional healthcare infrastructure.

The broader economic impact includes potential job losses—estimated at 69,000 in Texas—and challenges for small businesses that rely on stable healthcare options to support their workforce. Hospital and community leaders urge constituents to contact federal lawmakers to advocate for extending the enhanced premium tax credits to prevent these adverse outcomes. This situation highlights the critical interplay between federal policy decisions, insurance market stability, and the operational viability of healthcare providers in states with high uninsured populations.