Vice President JD Vance claimed that Democrats wanted to shut down the government because “they want to give hundreds of billions of dollars of health care benefits to illegal aliens.” That statement isn’t just misleading — it’s dangerously false.
The truth is, undocumented immigrants are excluded from all federal health insurance programs — including Medicare, Medicaid, and Affordable Care Act (ACA) marketplace coverage. Yet despite being locked out, they contribute nearly $100 billion annually in federal, state, and local taxes, according to 2022 estimates.
So if immigrants aren’t getting this money, who is losing it?
Millions of American citizens, including families right here in Ohio, are facing a genuine health care cliff. The expanded ACA premium tax credits — first enacted in 2021 — are set to expire at the end of this year. If Congress fails to act, millions of working households will see their premiums skyrocket overnight.
Before 2021, the ACA used a hard income cutoff to determine eligibility for premium tax credits. Households earning just over the threshold received no subsidies even if their premiums consumed a quarter of their income. That “subsidy cliff” made ACA plans unaffordable for many middle-income families, especially those just above the line.
The 2021 reforms fixed that flaw, capping premiums at 8.5% of household income for everyone, based on benchmark silver plan for their region. This made coverage finally affordable for everyone.
Now Congress may let that progress disappear.
My husband and I live in Ohio and fall just over the $84,600 threshold. If these credits expire, our annual premium will likely double to roughly $35,000. That’s not a sustainable budget line for any family, let alone retirees or small business owners. It’s a return to a broken system where middle-income taxpayers are punished for earning slightly too much to qualify for help, yet far too little to absorb the cost.
Republican lawmakers say extending these credits is “too expensive.” But the math tells another story. The cost of extending ACA credits would average about $35 billion a year, looking at a number of sources — less than the $44 billion annual increase authorized for mass deportations under the new “Big Beautiful Bill.” The Trump administration is choosing to pour more taxpayer dollars into mass roundups of long-time residents, rather than preserving affordable coverage for American families.
This isn’t fiscal conservatism. It’s fiscal hypocrisy.
When politicians spread myths about immigrants draining our health care system, they shift attention away from real policy choices hurting their own constituents. It’s not “illegal immigrants” who will lose coverage in 2026 — it’s millions of taxpaying Americans who depend on ACA credits to stay insured.
Health care affordability isn’t a partisan issue. It’s a kitchen-table issue. Ohioans know what it means to watch costs rise while wages stay flat. We know what it’s like to make impossible choices between medical coverage and mortgage payments.
I’ve written to my congressional representatives explaining how these cuts will affect us personally. The only responses I’ve received are form letters celebrating the “Big Beautiful Bill” and its massive spending increases — none addressing the loss of coverage for real families.
It’s time for leaders to stop playing politics and start practicing responsibility. Extending ACA premium tax credits isn’t a handout — it’s a lifeline for working households and a smart investment in public health and economic stability.
Linda McCarty of Medina runs a home rental business in her retirement.Courtesy of Linda McCarty
Rather than funding mass deportations that produce no measurable benefit, Congress should protect affordable health care for the people who fund this country — and who count on it.
Because the real threat to American health care isn’t immigration. It’s indifference.
McCarty runs a home rental business in her retirement. She writes from Medina.
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