Health insurance isn’t a luxury — it’s a necessity. But unless Congress acts soon, more than 420,000 Utahns — nearly one in eight residents — could lose access to affordable coverage when federal premium assistance for marketplace plans expires on Jan. 1, 2026.
These tax credits are not an abstract policy. They are what allow working families — too often caught in the middle, earning too much to qualify for Medicaid but not enough to afford rising private insurance premiums — to stay insured. Without them, Utahns will face impossible choices between paying for coverage or going without.
Consider a young family in Utah County with two children. Both parents work full time, but neither employer offers health insurance. Through the federal marketplace, they can afford coverage that ensures their children receive regular checkups and vaccinations. Without premium assistance, their monthly premiums would more than double — forcing them to choose between health insurance and the mortgage payment. This is the reality for thousands of families across our state.
Today, Utah has the fourth-highest marketplace enrollment rate in the nation, according to the Kem C. Gardner Policy Institute. A large share of these enrollees are children under 18, and Utah leads the nation in the proportion of minors who rely on marketplace plans. For many families, this means their kids see a primary care doctor for preventive care rather than waiting until illness forces an emergency room visit.
The difference matters — for both health and costs. When people lack insurance, they delay care until they are much sicker, leading to more ER visits, worse outcomes, and higher costs that strain both families and hospitals. Marketplace coverage keeps Utahns connected to care earlier, reducing reliance on emergency departments and saving the system millions of dollars.
This isn’t just about health; it’s also about Utah’s economy. Our state consistently ranks among the best for small business growth. Entrepreneurs and small employers often can’t afford to provide traditional insurance plans, but they can attract and retain workers when affordable marketplace coverage is available. Enhanced premium assistance has become a key part of Utah’s strong labor market and low unemployment rate.
Critics of the marketplace often argue that something “better” could replace it. But until a better plan exists, letting these tax credits expire would leave families with nothing. For hundreds of thousands of Utahns — including parents raising young children and small-business owners working to grow our economy — there is no alternative to affordable marketplace coverage.
Congress has a choice: allow coverage for 420,000 Utahns to collapse, or extend premium assistance and keep Utah families, workers, and businesses healthy and secure. The right path is clear.
Utahns take pride in our traditions, our strong families and our entrepreneurial spirit. Preserving access to affordable private health insurance honors those values and protects what makes our state strong. Extending this assistance should not be a partisan issue — it is about safeguarding families, reducing pressure on our hospitals and keeping Utah’s economy competitive.
I urge Congress to act this year — because Utah families, children and small businesses cannot wait.