U.S. Representative Terri Sewell, D-Alabama, called for the continuation of Affordable Care Act subsidies during a Saturday live stream.
Enhanced premium tax credits, or ePTCs, are federal subsidies for health insurance enacted by the American Rescue Plan Act in 2021 and extended by the Inflation Reduction Act in 2022.
The credits have been administered yearly through the ACA’s Health Insurance Marketplace. However, ePTCs are currently set to expire at the end of 2025.
During a weekend iteration of her “Terri Talks” social media events, Sewell spoke to a resident of her district who utilizes ePTCs and reflected on the credits’ value to Americans, and how Congress’s failure to reach a consensus on healthcare funding led to the federal government shutdown, which began on October 1.
“At a time when Americans are already being crushed by high costs of living, letting these tax credits expire would only push healthcare further out of reach for the average Alabama family,” Sewell said. “For months, my Democratic colleagues and I have made it clear that we’re willing to negotiate with Republicans on a bill to keep the government open and protect the healthcare of the American people.”
Senate Democrats have cited the lack of a Republican plan to extend ePTCs as reasoning for blocking the passage of a Republican-backed continuing resolution to fund the government until November 21, voting for the fifth time on Monday not to approve the bill.
Sewell cited that 22 million Americans are currently enrolled in ePTC healthcare plans nationwide, including 53,000 in her district.
She also emphasized that the premiums ending would increase average Marketplace premiums, reporting that an average four-person family in her district earning $64,000 a year would see an annual premium increase of $2,571.
Healthcare nonprofit, the Kaiser Family Foundation, has reported that the expiration of ePTCs would cause a 114 percent increase in the average annual cost of Marketplace premiums. The organization also reported that, since the introduction of ePTCs, Marketplace enrollment has more than doubled.
“[Republicans] left American people to deal with the consequences of their own healthcare crisis, and I think this has been a reckless shutdown, but it’s a shutdown of the Republicans and President Trump’s making,” the congresswoman said. “They control all three levers of government. They could end this madness today.”
Sewell was joined by Virginia Hutchinson, a Birmingham resident who currently relies on ePTCs to subsidize her ACA healthcare plan.
“This is about more than numbers on a page. It’s about the lives and livelihoods of the people that I represent,” Sewell said. “This fight is about real people with real stories, and I am grateful today to be joined by one of my constituents.”
Hutchinson, an Alabama native, emphasized the difficulty of finding a healthcare plan while searching for a job after returning to the Birmingham area after living out of state.
“It was a difficult time when there was a lot of uncertainty in my life, and I realized I needed to look into the Affordable Care Act, because you know if I ran out of healthcare and hadn’t found a job in time, I have some chronic health issues where I take daily medications,” Hutchinson said.
She said that having her healthcare subsidized through ePTCs allowed her to take a job at a small business without healthcare benefits and still afford her monthly healthcare costs.
“Because health insurance is so complicated, a lot of small businesses—it’s not affordable to buy a plan for their employees if they have less than 50 employees,” she said. “Because I was on the ACA, I was able to, you know, accept that job offer, and I’m still working full time and using an Affordable Care Act plan today.”
Sewell went on to respond to claims from Republicans and her constituents that the Senate Democrat-backed continuing resolution would provide healthcare for illegal immigrants.
Alabama Republicans U.S. Senator Katie Britt, U.S. Senator Tommy Tuberville, U.S. Representative Barry Moore and U.S. Representative Gary Palmer, have all pinned responsibility for the shutdown on Democrats over social media, claiming their stopgap funding demands would provide immigrants illegally present in the country with free, taxpayer-funded healthcare.
Sewell emphasized that providing federally funded health insurance to undocumented immigrants is illegal.
The Democratic continuing resolution would not have provided healthcare plans to undocumented immigrants; instead, the bill would reverse clauses of the OBBB, capping the amount of Medicaid funds hospitals receive for uncompensated emergency care given to immigrants, as well as a clause excluding Medicaid enrollment for non-permanent residents in the country legally through asylum or parole programs.
“It is not legal for them, for us to use taxpayer money to pay for illegal immigrants, for their healthcare, whether that’s Medicaid, Medicare, for their food stamps. I mean, this is against the law,” Sewell said. “We’re talking about saving the healthcare of Americans.”
Sewell and Hutchinson urged Senate Republicans to strike a deal with Democrats to keep ePTCs in place, emphasizing that time is running out since open enrollment for Healthcare Marketplace plans for 2026 is set to begin on November 1.
“To me, this isn’t—it shouldn’t be a partisan issue because everyone, regardless of their political affiliation, deserves good healthcare,” Hutchinson said. “A lot of people here voted for Trump, voted for Republicans, and I hope that their Republicans support them by supporting our healthcare system.”
“I wonder if Trump would be interested in hearing what you know an ordinary American would have to say about this issue,” Hutchinson said when asked by Sewell what her message to the president on ePTCs would be.
“Trump ran on talking about making life affordable for everyday Americans, talking about the economy. He also did a lot of talking about the art of the deal, you know. It’s time to make a deal,” she added.
KFF released a poll last week, which found that three out of four adults questioned about ePTCs supported the premiums’ extension, including 92 percent of Democrats and 59 percent of Republicans polled.
KFF reported that 93 percent of ACA Marketplace enrollees received premium tax credits in 2025. KFF also found that in 2025, 77 percent of ACA Marketplace enrollees live in states Trump won in the 2024 election, with Alabama being among states where 98 percent of Marketplace enrollees received ePTCs.
Cover Alabama, a nonpartisan coalition of over 100 healthcare providers, businesses and advocacy groups, has urged Congress to extend ePTCs, reporting that roughly 130,000 Alabamians will lose healthcare coverage if the premiums expire.
A report from the Robert Wood Johnson Foundation also found that the end of ePTCs would “be more pronounced in states that have not expanded Medicaid, communities in the South, and rural communities.”
The organization reported that in Alabama, healthcare providers would lose $939 million in annual revenue and see an 18.3 percent increase in uncompensated care demand should ePTCs expire.
Sewell is set to host a live telephone town hall on Wednesday, fielding questions from her constituents regarding the federal government shutdown and healthcare debate.
