Today, we are asking for your help contacting Congress to urge them to extend the enhanced premium tax credits (EPTCs) and protect access to health care for Tribal communities!
Background
On December 4, 2025, NIHB sent a letter to Congressional leadership highlighting the importance of the enhanced premium tax credits (EPTCs) and urging them to extend them beyond the end of this year. Currently, the federal government offers EPTCs that lower monthly premiums for eligible individuals, making marketplace coverage more affordable and accessible. In 2021, Congress increased and expanded eligibility for the EPTC. However, those policies are scheduled to expire on December 31, 2025.
Concerns for Tribal Communities:
American Indians and Alaska Natives (AI/AN) access the marketplaces for healthcare coverage like all Americans and rely on this coverage to support their access to healthcare both within and through referral by the Indian health system. Without an extension, premiums will increase significantly, making coverage unaffordable, and an estimated 126,000 AI/AN people will lose their Marketplace coverage. It is critical that Congress pass a straightforward extension of the Enhanced Premium Tax Credits.
Key Points Highlighted by NIHB:
- The Indian Health Service relies heavily on billing insurance companies for services provided to patients with coverage, including from Affordable Care Act marketplace insurance plans.
- Approximately 318,000 American Indians and Alaska Natives are enrolled in an ACA marketplace insurance plan utilizing the Enhanced Premium Tax Credits. An estimated 126,000 AI/AN people will lose their Marketplace coverage without an extension of the EPTC because coverage will no longer be affordable.
- It is essential for Congress to enact a straightforward extension of the Enhanced Premium Tax Credits to help the United States fulfill its obligations to Tribal Nations, communities, and citizens.
How To Take Action:
1. Identify and Contact Your Representatives. Click here to confirm and Call call or email your congressional representatives to express your support for extending the enhanced premium tax credits and for fully funding the Tribal health system.
a. Send a Letter to Your Representative (click for template)
b. Call Your Representative. Here’s a recommended script: Hello, my name is [STATE NAME], and I am a citizen of [TRIBE] and a constituent of [CONGRESSIONAL MEMBER NAME]. I’m calling today to express my concern about the expiring enhanced premium tax credits. The Indian Health System relies heavily on third-party revenue, like that collected by marketplace insurance plans, to deliver high quality healthcare services to American Indians and Alaska Natives. The enhanced premium tax credits are a lifeline for our Tribal citizens staying on marketplace insurance plans and accessing healthcare services. I urge [Representative/Senator XX] to vote for a clean extension of the enhanced premium tax credits.
2. Share Your Story: NIHB wants to hear from you! If you have a story about the impacts of the expiring enhanced premium tax credits, please send to [email protected]
Thank you for your continued support and dedication to Tribal health. Together, we can ensure our communities receive the care and resources they need.
