Opinion: This New Year, Congress Must Fix Our Country’s Health Care Crisis

I’m a Kinship Navigator and Community Resource Specialist at The River Center Family and Community Resource Center. We’re a small nonprofit serving families and individuals across ten rural New Hampshire towns — about 3% of the state.

In my role, I spend thousands of hours each year supporting the communities I love. Every hour I spend with a scared mother, a grieving grandmother, or a worried senior is about building trust, creating connection, giving families hope, and helping them feel less alone. Behind every number is a person, a family, a story.

So, when I talk about the end of the Affordable Care Act’s (ACA) enhanced premium tax credits, I’m not speaking in theory or politics. I’m speaking from the front lines of what it looks like when families are pushed to the breaking point. Nearly 50,000 people in New Hampshire who are enrolled in ACA marketplace plans receive advanced premium tax credits –  and I’m one of them.

The ACA marketplace is the only reason my husband and I have health insurance. Last year, with the enhanced premium tax credits in place, we paid $116/month for my husband and me. Even that was tough. Our plan had a high deductible and hefty copays, so we still had to shell out a lot of cash for just routine care.

Now, we’re tumbling over the health care cliff. Without the tax credits, that same $116/month plan this year was nearly $450 each month. 

We ended up finding a somewhat cheaper plan with similar, albeit still higher deductibles, copays, and prescription costs, but the new premium is still unaffordable. We are now paying $286/month, and the copays and prescription costs will be even higher than last year’s. 

Personally, I have a few new health conditions, and I will need education on how to manage them, and I will now need to see multiple specialists a few times a month. Each visit with a specialist carries a copay of $60 out of pocket. 

Additionally, I am in need of surgery to improve my quality of life. That surgery might not happen. We simply don’t have room in our family’s budget for these new costs. Our only option is to take on medical debt.

That’s not a rounding error. That’s a cliff. And it’s one my family of four cannot climb.

We are already stretched thin. My husband and I are raising a disabled teenager who needs consistency, stability, and access to care. I also have a 14-year-old daughter who is watching me, what I am doing, what choices I am making, and learning what it means to be an honest, hard-working American. It is my responsibility to teach her these lessons, and it is our elected officials’ responsibility to model for her what that means as well.

I also manage a mental health condition through daily medication and regular care. This allows me to stay focused, balanced, and effective, both at home and at work. Last year, I worked closely with around 100 families. Losing access to affordable healthcare would disrupt my continuity of care, making it much harder to support our disabled teenager and our daughter, maintain my professional responsibilities, and serve the families who rely on our programs.

Affordable treatment is not a personal luxury; it’s essential for the stability and well-being of my family, my work, and the wider community.

This is my reality. And my situation is not unusual. In New Hampshire, one in seven non-government workers is employed by nonprofits. Non-profits are a major part of NH’s economy, and we are the backbone of community care, but many of us do not receive employer-sponsored insurance. 

For example, my employer is a very small nonprofit. Due to cuts made by the Trump Administration, thousands of dollars were removed from our already slim budget, money we will never get back. We simply cannot afford to offer staff health insurance. 

That means the ACA Marketplace is my only path to coverage. And when those supports are reduced or removed, nonprofit workers like me, and thousands of others across the state, are left with nothing. And it’s happening to millions of Americans. But I’m here to say that the ACA premium tax credits work. They make healthcare possible for millions who would otherwise go without. They stabilize families, communities, and, yes, even the nonprofit workers who serve them. 

That’s why I’m so encouraged that the U.S. House of Representatives just voted to extend these credits – and why families are counting on the Senate to do the same without delay. 

Behind every policy is a person. Behind every number is a name, a face, a story. I am one of them, and I am speaking out because I refuse to give up hope. We are not asking for special treatment. We are asking for fairness, compassion, and the basic dignity of affordable health care.