WATCH: In Senate Aging Committee Hearing, Kelly Highlights Risks to Health Care Coverage and Affordability for Older Arizonans

Today, during a Senate Special Committee on Aging hearing, Arizona Senator Mark Kelly raised concerns that the expiration of the Affordable Care Act (ACA) premium tax credits, new federal marketplace restrictions, and upcoming Medicaid funding cuts could drive up costs and limit coverage options for older Arizonans who rely on ACA plans before becoming eligible for Medicare.

During the hearing, Kelly underscored what's at stake for older Americans: "With the expiration of the enhanced ACA premium tax credits and some new federal enrollment restrictions taking effect, I think it's fair to say that the progress we've made is at risk. In Arizona, many older adults and working families rely on marketplace coverage for insurance before they are eligible for Medicare. I've spoken to many of them […], these are real people. But looking beyond next year 's enrollment, the combination of the tax credit expirations and the administration 's new rules and Medicaid funding cuts that are coming- this could leave Americans with higher premiums without a lot of options."

Kelly shared stories from older Arizonans he spoke to whose coverage and financial stability are at risk: "Dennis is 66 years old. He's on Medicare, his wife is not. He lives in Lake Havasu City. […] His wife is 62. She depends on ACA coverage until she's 65, so they've got 3 years of trying to deal with this. They pay $440 a month for her insurance through the ACA, but they get a $720 tax credit. So, when these tax credits lapse, her premium will go from $444 to $1100 a month […]. They're not going to be able to live out their retirement dreams now because their excess income that they had is going to go for insurance. That's it."

Kelly continued: "But it gets worse for other people. Robin, a 60-year-old woman from Sedona, says the expiration of ACA subsidies could lead to significant increases in our healthcare costs because she also gets a premium tax credit. She said it's going to make her have to decide between rent and healthcare. It's that simple for millions of people across the country: having a place to live or having healthcare insurance. And she told me that she is not looking for a handout. She's looking for a hand up."

Kelly warned that these changes could raise costs for older Americans.

Click here to watch his full exchange with witnesses. See the transcript below:

Sen. Kelly: Thank you, Mr. Chairman, and thank you to all of our witnesses for being here today. I'm going to start with the Dr. Lambrew. Thank you for your work on implementing the Affordable Care Act which made coverage more affordable for millions of folks across the country, including in Arizona, the state that I represent.

Now, with the expiration of the enhanced ACA premium tax credits and some new federal enrollment restrictions taking effect, the progress, I think it's fair to say that the progress we've made is at risk. In Arizona, many older adults and working families rely on marketplace coverage for insurance before they are eligible for Medicare. I've spoken to many of them, and when Senator Justice talks about names and families, these are real people. I've talked to many of them over the last couple weeks.

But looking beyond next year 's enrollment, the combination of the tax credit expirations and the administration 's new rules and Medicaid funding cuts that are coming-this could leave Americans with higher premiums without a lot of options. In Arizona, these aren't abstract numbers: they are real families. Real people. A guy I spoke to just a couple days ago named Dennis is 66 years old. He's on Medicare, his wife is not. He lives in Lake Havasu City. He worked in ship repair for over 33 years, never went to college, just went to high school, but became a project manager. His wife is 62. She depends on ACA coverage until she's 65, so they've got 3 years of trying to deal with this. They pay $440.00 a month for her insurance through the ACA, but they get a $720.00 tax credit. So, when these tax credits lapse, her premium will go from $444.00 to $1100.00 a month.

And this threatens their retirement plans. This guy's worked really hard-they've got 6 kids that are nieces and nephews that they raised. They're not going to be able to live out their retirement dreams now because their excess income that they had is going to go for insurance. That's it.

But it gets worse for other people. Robin, a 60-year-old woman from Sedona, she says the expiration of ACA subsidies could lead to significant increases in our healthcare costs because she also gets a premium tax credit. She said it's going to make her have to decide between rent and healthcare. It's that simple for millions of people across the country: having a place to live or having healthcare insurance. And she told me that she is not looking for a handout. She's looking for a hand up.

So, can you speak to the broader economic and health system effects that we could see if these policies lead to large coverage losses? How is it going to affect states like Arizona, and West Virginia, and Florida, and New York, and Kansas. You know, places that have rural areas. What should we expect to see?

Dr. Jeanne Lambrew: Thank you for that question. To talk first about the uninsured, and then about reduced enrollment: we had hit a record low percentage of Americans who are uninsured in 2022 and 2023 and 2024. We'd actually never done better. But the Congressional Budget Office projects that a few years out, the number of uninsured in this country will increase by 50% as a result of these changes plus the Medicaid changes that are on the horizon.

We know from our hospitals and health systems and other providers who try to provide care to people who may not be able to pay, may not be able to afford it-it will strain the healthcare system, which could mean more rural hospitals close, mean more clinics really struggle to keep their hours, to keep their nurses, to really survive in a climate with less reimbursement. So, there will be health system effects, not just for those directly affected, but anybody in that rural community who may not be able to get the services that can no longer be sustained. There's also a broader economic effect. Mister Cuban talked about small businesses needing this kind of support for their workers to stay healthy. We have an estimate that 339,000 jobs could be lost just because of the expiration of these premium tax credits, because it affects hospitals, it affects communities that are around those hospitals, and that translates into $2.5 billion lost revenue every year for state and local governments. So, those are just 2 examples of the health system and the economic effects of not continuing these tax credits.