1. United States
2. Ore.
3. Letter

I am writing as your constituent to urge you to protect and extend the Affordable Care Act (ACA) and its enhanced premium tax credits. Letting these protections and subsidies expire would be devastating for millions of Americans. Since the ACA’s major provisions took effect, more than 38 million people have gained coverage and the uninsured rate has nearly been cut in half, from 14.4% in 2013 to 7.9% in 2023 (https://www.shadac.org/news/15-years-affordable-care-act-more-americans-ever-have-health-insurance-coverage). In 2024, about 44 million people were enrolled in coverage through the ACA marketplaces or Medicaid expansion—roughly 1 in 6 non-elderly Americans (https://www.kff.org/affordable-care-act/affordable-care-act-marketplace-and-medicaid-expansion-enrollment-reached-a-combined-44-million-in-2024/). Allowing these pillars to lapse would reverse more than a decade of progress. Recent analysis of ACA-related rollback legislation shows what is at stake. The Congressional Budget Office estimated that a recent House reconciliation bill—similar in impact to past ACA repeal efforts—would lead to about 16 million people losing health coverage, including nearly 11 million losing Medicaid and about 5 million losing marketplace coverage (https://www.medicarerights.org/medicare-watch/2025/06/05/official-house-bill-analysis-confirms-devastating-coverage-losses; https://www.brookings.edu/articles/new-cbo-estimates-show-2025-reconciliation-bill-would-have-impacts-similar-in-magnitude-to-2017-aca-repeal-bills/). That is not an abstract number; those are our neighbors, co-workers, and family members. If enhanced ACA subsidies expire, many people will be priced out of coverage. A recent KFF/Reuters survey found that about a quarter of ACA enrollees say they would likely go uninsured in 2026 if subsidies end and premiums double (https://www.reuters.com/business/healthcare-pharmaceuticals/obamacare-premium-spikes-could-drive-off-enrollees-most-want-subsidy-extension-2025-12-04/). Premium spikes and coverage losses will mean more medical debt, more delayed care, and more uncompensated care that strains hospitals and state budgets. The ACA also protects people with pre-existing conditions. Analyses have found that over 100 million Americans live with conditions that could put their coverage or premiums at risk if these protections disappear (https://advisory.avalerehealth.com/press-releases/repeal-of-acas-pre-existing-condition-protections-could-affect-health-security-of-over-100-million-people). In addition, the ACA guarantees no-cost coverage of many preventive services—such as blood pressure checks, diabetes and cholesterol tests, and cancer screenings—so people can catch disease early instead of in the ER (https://www.healthcare.gov/coverage/preventive-care-benefits/; https://healthpolicy.fsi.stanford.edu/news/millions-could-lose-no-cost-preventive-services-if-scotus-upholds-ruling). Rolling back these provisions would lead to more late-stage illness and higher long-term costs. I urge you to: Extend and make permanent the ACA’s enhanced premium tax credits; Preserve and strengthen Medicaid expansion; Protect pre-existing condition safeguards; and Maintain guaranteed, no-cost preventive services. Please put the health and financial security of your constituents ahead of short-term politics. The ACA is working; do not allow its core protections to expire.