From groceries to school supplies, hardworking Oregonians are seeing the cost of everyday items steadily climbing. And now, for many families, things could get a lot worse in a hurry.

Earlier this year, the Republican majority in Congress passed a massive bill that will make it harder for low-income Oregonians to put food on the table and access the health care they need. Along with these budget cuts, coupled with lavish tax cuts to the rich and corporations, the massive bill failed to renew a tax credit that families use to purchase health insurance on the Affordable Care Act health exchanges — a failure that could have catastrophic consequences for many families. 

The enhanced premium tax credit helps more than 111,000 Oregonians – about 80% of all Oregonians who get their health coverage through the marketplace. Of these, about 35,000 with incomes above 400% of the federal poverty level would no longer qualify for any help if the enhanced tax credit expires at the end of December. This means that many families will see their health care costs soar, and many will not be able to afford health coverage at all. 

According to the Oregon Health Authority, Oregonians getting their insurance on the health care Marketplace “could pay an average of $127 – $456 more per month, depending on their income level.” That translates to about $1,500 to $5,500 more per year, making health coverage unaffordable for many. 

Some could see much bigger increases. Consider a married couple in their early 60s living in Oregon City who together make about $85,000 per year, about 400% of the federal poverty level. Because their employer does not provide them with health insurance, they buy their health coverage through the Marketplace. They have been able to afford their health insurance thanks to the premium tax credit, which up until now has paid about 70% of the cost of a “silver” plan — a middle-of-the-road plan. But if the enhanced premium tax credit goes away, that couple will see the cost of health coverage balloon from about $7,200 per year — already a hefty load for this family — to more than $24,000 per year, a figure way out of reach.   

Many of those affected will be small business owners and self-employed workers. In Oregon, nearly 18,000 self-employed workers and more than 29,000 small business owners rely on the health insurance marketplace to obtain their health coverage. Of these, about 77% rely on the enhanced premium tax credits to afford health insurance.

For those able to hang on to their health insurance, the cost increase means even more strained family budgets. Without affordable health coverage, parents will no longer be able to take their children to a doctor if they are sick. Cancer patients won’t be able to afford lifesaving medication and treatment.

Especially hard hit will be Black and Latino Oregonians. Thanks in part to these health tax credit enhancements, the rates of health coverage have increased by more than 150% for these groups nationally. Yet, the loss of the premium tax credit enhancements means their health coverage will be essentially taken away by making it unaffordable.

It’s also important to stress that the harm will spread far beyond those families and individuals who buy their health insurance with the premium tax credits. As people, especially those who are in good health, drop their health insurance coverage due to the rising cost, the group of people who stay insured will tend to have higher health care needs, causing insurance companies to raise rates for those who keep their coverage. 

While the tax credits don’t expire until the end of the year, many insurance companies are already projecting sharp hikes to insurance rates. According to the Kaiser Family Foundation, insurers are already filing for rate increases that are 4 percentage points higher than they would be if the enhanced tax credits were renewed.

Bear in mind, the loss of the enhanced premium tax credits is only one — and not the biggest — of the cuts to health care in the Republican budget. Even more far-reaching are the cuts to Medicaid, which will begin rolling out in 2026. By 2034, as many as 213,000 Oregonians could “lose health coverage and become uninsured,” according to the Center on Budget and Policy Priorities.

Oregonians are already struggling with high prices across the board, and the expiration of the enhanced premium tax credits will only make matters worse. If the Republican majority in Congress doesn’t act, working families and small business owners across Oregon will pay the price.