Expiring ACA tax credits threaten Black families in major metropolitan areas, new report finds

The expiration of Affordable Care Act (ACA) premium tax credits will result in major coverage losses and financial harm for Black Americans across some of the nation's largest metropolitan areas, according to a new analysis from the Economic Policy Institute and Groundwork Collaborative.

With the Republican-led Congress failing to extend the ACA tax credits in January, the report examines the consequences in 10 major metro areas with large Black populations-Atlanta, Chicago, Dallas, Detroit, Houston, Los Angeles, Miami, New York, Philadelphia, and Washington, D.C. Key findings include:

• The number of Black residents without health insurance could increase by as much as 24% in major metro areas. The largest increases in Black uninsurance rates would be found in the Atlanta, Dallas, and Houston metro areas. Losing the subsidies will substantially reduce coverage for Black families because they are both more likely to live in states without Medicaid expansion and more likely to face uninsurance due to lower and less stable incomes.
• The ACA credit expiration could lead to more than 200 preventable Black deaths each year . These deaths stem directly from the loss of affordable coverage and reduced access to timely care.
• Black families could pay $740 million more in annual premium costs. Black families who are able to keep their health insurance would be squeezed by higher health care costs, further straining already tight household budgets.
• Local economies could lose more than $1.9 billion each year . Atlanta, Dallas, and Houston metros would lose the most economic activity as federal subsidies disappear and household spending contracts because families must redirect more of their income toward higher premiums and away from spending on local goods and services.

"Allowing the ACA premium tax credits to expire will make it harder for families to access health care, worsen an ongoing affordability crisis, and negatively impact local economies. Black workers and their families will feel these shocks most acutely," said EPI economist Kyle K. Moore, who co-authored the report. "Acting to reinstate and extend the ACA premium tax credits is equity-enhancing, race-conscious economic and public health policy."

"Doing away with the enhanced ACA tax credits causes real harm to real people, especially in communities already under severe economic strain. Behind these numbers are families facing impossible tradeoffs between health care and other basic needs amid an affordability crisis and a weakening labor market," said Groundwork Collaborative chief economist Breyon Williams, who co-authored the report.