Caregiving runs deep in my family. Through my role at ComForCare Winston-Salem, I’m humbled to carry on the tradition my great-grandparents and grandparents started when they first built nursing homes in the Piedmont Triad and western North Carolina more than 70 years ago.
This is why I’m worried about what could happen if Congress fails to extend the enhanced premium tax credits that make health insurance affordable for North Carolinians, especially older people living on tight budgets who aren’t yet eligible for Medicare. It’s an issue that should be getting more attention in Washington, D.C.
Every day, my teams work with vulnerable North Carolina seniors who deserve this attention. We help them with Alzheimer’s care, personal needs, meal assistance or recovery after a hospital stay. I’m proud of the role we play in helping seniors maintain their independence as they age. And when a family tells me of the relief someone from our team brought them in the middle of a crisis, I’m reminded that dignity and compassion are why caregivers follow our calling.
The enhanced premium tax credits help reduce monthly premiums and improve access to critical care. Premium reductions average around $700 per enrollee nationwide. They have helped more than 24 million Americans — including nearly a million North Carolinians — more easily afford high-quality coverage through the individual health care marketplace. But these credits are set to expire at the end of 2025. If Congress doesn’t act, premiums will skyrocket, and families across North Carolina will feel the squeeze immediately.
Huge premium spikes would result. According to an analysis by FTI Consulting, a family of four making $64,000 a year could see premiums rise by over $2,500 a year. This increase would more than wipe out the $700 in estimated tax savings this same family is expected to see under the One Big Beautiful Bill Act (OBBBA). Moreover, North Carolina working families are left with a net budget shortfall of more than $1,800.
The premium math is even more concerning for seniors. A 60-year-old couple earning $82,800 would face a massive premium hike of more than $18,000 if lawmakers allow the enhanced premium tax credits to expire. Compare that astonishing figure with the $290 a year they could see under OBBBA. This disparity is not tax relief; it’s a financial disaster.
I see every day how fragile financial security can be for families juggling health care costs, caregiving and retirement. Tens of millions of Americans don’t get coverage through an employer — they depend on the marketplace to stay insured. If Congress lets these tax credits expire, many of these hardworking Americans will lose coverage altogether.
This is not a partisan issue, or at least it shouldn’t be. Voters across the political spectrum understand how important these tax credits are for our country. In fact, 86% of Americans — including 82% of Donald Trump voters — want Congress to extend them. It’s not a surprise that protecting affordable health care has broad public support. Families are already stretched thin by inflation and higher costs in nearly every part of their lives.
Time is running out for Congress to extend these tax credits before the end of the year. Congress will soon consider a major health care spending package in September, and lawmakers must include an extension of this lifeline. North Carolina’s congressional delegation — including Sens. Ted Budd and Thom Tillis and Rep. Addison McDowell — have a choice: They can secure affordable coverage for nearly a million North Carolinians, or they can allow premiums to double and erase the promise of tax relief.
Extending the tax credits is more than good policy. And the patients and families we serve are more than numbers on a budget sheet. They are parents, grandparents and neighbors trying to hold on to their health and their independence. Preserving the enhanced premium tax credits means fewer families are forced to choose between coverage and other necessities — and more North Carolinians are able to live with dignity.
This is what caregiving is all about, and this is why Congress must extend the credits before it’s too late. Lawmakers can’t push this to the back burner anymore.
Ryan Gragg is the owner of ComForCare Home Care of Winston-Salem.