1. United States
2. La.
3. Letter

The One Big Beautiful Bill Act makes significant changes that would severely undermine the Affordable Care Act's (ACA) health insurance marketplaces and result in millions of Americans losing their coverage. These policies impose burdensome administrative requirements on enrollees, remove key enrollment flexibilities, and reduce available financial assistance, ultimately pricing many out of affordable coverage options. Some of the most concerning provisions eliminate automatic re-enrollment for those receiving premium tax credits, end provisional eligibility for tax credits while awaiting verification, remove repayment caps for excess premium tax credits, shorten the open enrollment period, and end income-based special enrollment periods. Additionally, failing to extend the enhanced premium tax credits would increase premiums and cause over 4 million to lose coverage. These drastic changes threaten the stability of the marketplaces and access to comprehensive health insurance for millions who rely on this coverage, including small business owners, self-employed individuals, and low-wage workers. When individuals lose coverage and become uninsured, they often defer needed care until their conditions worsen, increasing costs for all. Local hospitals and providers end up providing more uncompensated care, straining resources. We urge the Senate to reject the House bill's harmful provisions impacting the ACA marketplaces. These sweeping coverage losses would undermine over a decade's progress in expanding access to affordable health insurance and negatively impact families, communities, and our entire health care system. Maintaining robust, stable marketplaces is crucial for ensuring all Americans can access the care they need.