Portability, Affordability, and the Care Infrastructure We Need

Families at the Breaking Point: Navigating care, coverage, and crisis at year’s end.

By Mark Fukae - Director of Advocacy - Professionals Who Care

Healthcare professionals know the truth: affordability is the beating heart of care. Without stable coverage, families delay treatment, caregivers burn out, and providers face rising reconciliation errors.

This week, Congress failed to extend ACA subsidies, leaving millions at risk of premium spikes in January. House proposals focus on employer flexibility and health savings accounts, but these short-term fixes don’t stabilize markets or protect patients.

Professionals who care - nurses, doctors, social workers - see the impact every day. Families at the breaking point, caregivers stretched thin, and systems that treat care as optional instead of infrastructure.

📊 The latest Our Lives On Hold analysis explains why portability and affordability must be treated as human infrastructure, and how professionals can join caregivers in demanding systemic reform.

👉 Read “Families at the Breaking Point” on Substack

We are at the end of the year, and the stakes could not be higher. Premiums are rising, subsidies are expiring, and families are at the breaking point. Professionals who care must join caregivers in making legislators hear us.

I want to acknowledge the 661 supporters and 738 signatures already standing with us - your voices matter. But we must continue to amplify them.

📣 Here’s how you can help:

• Sign the Change.org  petition: The CARE Act: A Smart Investment for Working Caregivers in America & Colorado

• Share your voice with policymakers in your state

• Read and share our Substack series The Revenue Neutral Caregiver

Let’s get the word out. Legislators must understand that affordability, portability, and caregiver infrastructure are not partisan issues - they are survival issues.

📚 References

• Politico – “The Senate rejected dueling health care bills Thursday, all but guaranteeing that Obamacare subsidies used by more than 20 million Americans will lapse at the end of the year.”

• Washington Examiner – “A Democratic proposal for a three-year extension of the pandemic-era premium subsidies failed 51-48, and a GOP counterproposal to instead provide up to $1,500 annually to qualifying recipients for health savings accounts was shot down by the same vote tally.”

• Healthcare Dive – “Senate Democrats’ plan to extend more generous financial assistance for Affordable Care Act plans would increase the federal deficit by nearly $83 billion over a decade, but millions more would remain insured.”

• Axios – “House Republicans unveiled details of their health care plan Friday ahead of planned votes next week. The plan does not include an extension of enhanced Affordable Care Act subsidies. Instead, there are other GOP ideas aimed at lowering health care costs.”

• The Hill – “House Republicans on Friday unveiled a health care bill… but will exclude extension of expiring enhanced ObamaCare subsidies.”

• ABC News – “House Republicans unveiled Friday a narrow health care package to address rising costs, but the plan does not extend the expiring enhanced Affordable Care Act subsidies.”

• USA Today – “Republican Sens. Mike Crapo and Bill Cassidy unveiled a bill that would deposit $1,000 to $1,500 into health savings accounts for eligible consumers. This money would be in lieu of extending COVID-19-era enhanced tax credits that sharply reduced health premiums under the Affordable Care Act.”

• CNBC – “Enhanced subsidies for Affordable Care Act health insurance premiums are set to expire at year’s end if Congress doesn’t extend them. Health proposals from Senate Democrats and Republicans failed on Thursday.”

• CBS News – “Mahwah, New Jersey, resident Tina Jump recently learned that the premium for her Affordable Care Act health insurance is set to surge from about $400 a month to more than $1,100 starting in January — a nearly threefold increase that she says left her in a state of panic.”