Many Pennsylvanians, including thousands who live in the Lehigh Valley, will face health care sticker shock in 2026 if Congress fails to extend federal tax credits for individual health insurance coverage.
The looming loss of those tax credits will make insurance premiums more than double for some, which may force them to go without coverage for themselves and their families.
But the impact goes beyond those buying coverage through Pennie, the commonwealth’s health insurance exchange. The loss of these tax credits stands to have a ripple effect throughout the entire health care system that will push costs even higher while hindering health care quality for every one of us.
Health care costs are already escalating at an unprecedented rate due to many factors. Nationwide spending on prescription drugs exceeded $460 billion last year alone, according to the Centers for Medicare and Medicaid Services. That is a burden Americans shoulder more heavily than people in many other countries. We must take an honest look at how dynamics across the health care delivery system – including the trend toward provider consolidation, the growing complexity of care settings, and rising workforce costs – may be influencing pricing and competition. At the same time, advancements in medical technology that improve and even save lives come with significant expense. Tallied up, those factors and more make it challenging to keep health care affordable, which stresses the need for open and honest dialogue about the forces driving costs.
The expiration of the tax credits will only make things worse. Higher premiums likely will leave more people – including those who work for small businesses – uninsured and place added strain on families, employers, and communities across the Lehigh Valley. When people drop coverage, it sets off a chain reaction:
•Costs shift to those who remain insured (including frequent health care users), driving premiums higher across the board, including for those who get their health care coverage from their employer or through Medicare.
•Doctors, hospitals and clinics serving urban and rural areas must absorb the cost of caring for uninsured patients, which can jeopardize their financial stability.
•Local governments, Medicaid and public health institutions will be forced to pay more, squeezing already tight budgets.
•The human cost is also severe: without preventive care, chronic disease management, and timely treatment, people face worse health outcomes, deeper disparities in care, and real public health risk.
These are not abstract policy concerns. They are real-life challenges that Capital Blue Cross sees in our day-to-day work. That’s why we strongly support extending these tax credits. It’s not simply about making coverage affordable for individuals – it’s about preserving the stability of our entire health care system.
While we urgently call for the continuation of the tax credits, we also believe this moment can be a springboard for broader, constructive reform. Our health care system has flaws: too much complexity, too many administrative hurdles and persistent barriers to care. As a regional health plan deeply embedded in this region, Capital Blue Cross has seen where things break down. We are eager to help fix them.
We must drive, not dodge, conversations about modernizing care delivery, streamlining administrative burdens and improving collaboration among insurers, providers, employers and patients. Policymakers, insurers, and health systems can put partisan politics aside and focus on finding practical opportunities to build a more efficient system for all.
Here’s the key: reform should not come at the cost of taking away what currently works for millions of people. Abandoning the system without a tested alternative would be careless. Instead, the most responsible path is bipartisan and incremental.
Let’s build on the strengths of today, fix what’s broken, and do so in a way that protects coverage and access during the transition.
We all play a part. Yes, Congress needs to act and extend the enhanced premium tax credits, but we need to commit to a long-term, bipartisan process of real improvement. By doing so, we can ensure that Pennsylvanians and Americans more broadly have the peace of mind in knowing their health care remains accessible, affordable, and sustainable next year and beyond.
This is a contributed opinion column. Todd Shamash is president and CEO of Capital Blue Cross, which serves a 21-county region in Pennsylvania that includes the Lehigh Valley. The views expressed in this piece are those of its individual author, and should not be interpreted as reflecting the views of this publication. Do you have a perspective to share? Learn more about how we handle guest opinion submissions at themorningcall.com/opinions.
