1. United States
2. N.C.
3. Letter

I am a North Carolina constituent writing to urge—and expect—you to support a minimum three-year extension of the ACA premium tax credits. Allowing these subsidies to expire would be deeply damaging to families, rural communities, and healthcare providers across our state. More than 1 million North Carolinians are enrolled in ACA marketplace coverage, and the vast majority receive tax credits that make their insurance affordable. If the enhanced subsidies expire, premiums are projected to increase by roughly 75–90% for many enrollees, forcing thousands to drop coverage altogether. The impact would be especially severe in rural North Carolina. Over 80 of our 100 counties are rural or partially rural, where residents already face higher premiums due to limited insurer competition. Many rural counties have only one hospital, and several have none. When people lose coverage, uncompensated care rises—pushing rural hospitals closer to closure and leaving entire regions without access to emergency or specialty care. Extending ACA tax subsidies is not an abstract policy choice—it is a practical, immediate step to: - Keep working families and early retirees insured - Stabilize rural insurance markets - Reduce uncompensated care costs for hospitals - Protect local economies that depend on functioning healthcare systems Failing to act would raise costs on North Carolinians who are already struggling with inflation, caregiving responsibilities, and workforce instability. Healthcare affordability should not be a partisan issue. I expect you to put the well-being of your constituents first and to support a three-year extension of ACA tax subsidies to prevent unnecessary harm to North Carolina families and communities. I will be closely watching your actions on this issue.