An Alabama medical advocacy coalition has raised the alarm regarding potential Affordable Care Act premium increases projected for next year.
The Cover Alabama coalition is a nonpartisan alliance of over 100 healthcare providers, businesses, faith-based and community advocacy groups.
The organization cites its mission as “advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.”
Cover Alabama raised concerns in a Tuesday press release over data showing that nearly half a million Alabamians could see health insurance costs “rise dramatically” if Congress allows the expiration of certain federal tax credits at the end of 2025.
Enhanced Premium Tax Credits, ePTCs, are federal subsidies for health insurance enacted by the “American Rescue Plan Act,” and extended by the “Inflation Reduction Act,” which are administered yearly through the ACA’s Health Insurance Marketplace.
The subsidies are currently set to expire at the end of 2025.
Cover Alabama argued that ePTCs have “been critical in keeping health insurance accessible for Alabama families.”
The organization cited a report from Kaiser Family Foundation, a non-profit that provides information and research on U.S. healthcare policies and related issues, which found that overall, 477,838 Alabamians utilized Health Insurance Marketplace plans in 2025.
Cover Alabama also pointed to a 2024 KFF report, finding that the average cost of Healthcare.gov premiums in the state would nearly double, increasing by an average of 93 percent, if Congress does not extend enhanced subsidies.
KFF found that ePTCs have, on average, cut premium payments for ACA enrollees nationwide by an estimated 44 percent.
Cover Alabama also highlighted a KFF report showing the expiration of ePTCs combined with the effects of ACA Marketplace reforms laid out in the “One Big Beautiful Bill Act,” passed in July, would leave an additional 130,000 Alabamians uninsured by 2034.
“Without congressional action, families will face impossible choices between paying for health insurance or putting food on the table,” said Alabama Arise’s Cover Alabama Campaign Director Debbie Smith. “These are small business owners, older adults and working families who can’t absorb a hike in premiums. Congress has the power to prevent this crisis.”
“These numbers are not abstract — they represent real people in our communities,” Smith continued. “When health insurance becomes unaffordable, people delay care, skip prescriptions and end up sicker. Without Medicaid expansion, Alabama already lags behind in coverage. Losing these tax credits would make a bad situation much worse.”
Cover Alabama also linked to a study by the Commonwealth Fund, projecting that an end to ePTCs in 2025 would lead to $1.14 billion in lost economic activity for Alabama and the loss of nearly 10,000 jobs in 2026.
“Because Alabama has not expanded Medicaid to cover adults with low incomes, the state will feel the impacts even more acutely,” Cover Alabama wrote. “Hundreds of thousands of residents already fall into the ‘coverage gap,’ unable to afford private insurance but ineligible for Medicaid. The expiration of ePTCs would leave even fewer options for affordable coverage.”
Cover Alabama urged residents to contact their members of Congress and ask them to extend access to ePTCs and to sign their petition advocating for the continuation of the program.
