The Cliff of Good Health: Fighting Back Against ACA & Medicaid Cuts
Health Inequities Deepen Amid Cuts
Millions of Americans are being pushed off the Cliff of Good Health. Skyrocketing health insurance costs, a crumbling safety net, and attacks on public health have endangered families, including seniors, children, and people with chronic conditions.
The expired Affordable Care Act (ACA) tax credits and Medicaid cuts passed by Congress put up to 15 million Americans at risk of losing health insurance over the decade, and millions more face ACA premiums nearly 114% higher than the previous year. Nearly 24 million Americans were covered through the Affordable Care Act marketplace, including small business owners, self-employed workers, those in the gig economy (rideshare drivers, delivery workers, and creatives), those whose jobs didn't provide health insurance, and part-time workers. But a hostile political climate triggered devastating cuts across the board.
Black Americans are among the hardest hit. Already saddled with lower life expectancies and pervasive health disparities due to structural inequities, the recent policy losses pile on financial pressures and increase the likelihood that people will forego and delay even necessary care.
Why This Matters
- Although available data is incomplete, ACA sign-ups for 2026 are down by over 1 million people compared to this time last year, and the situation is expected to worsen, resulting in 5 million people losing health insurance.
- Expired ACA tax credits are likely to raise costs by $1,000 per person for more than 20 million people, including 6.5 million Latinos, 3.6 million African Americans, and 1.9 million Asian Americans and Pacific Islanders.
- Ending the tax credits is projected to impose high costs on Black Americans in 10 major metro areas, specifically, contributing to 200 preventable deaths a year.
- ACA cuts will bleed jobs from state economies, nearly 340,000, almost half of which are in health care.
Medicaid Cuts Could Cost Lives
Without action to counteract the losses to Medicaid and the ACA, up to 51,000 Americans will die annually, and more than 350,000 chronic illnesses will occur (such as high blood pressure, diabetes, and high cholesterol) each year.
Health Justice For Every Community
The NAACP fights for health justice, which ensures that everyone has access to the best conditions to achieve their highest level of health. To make this a reality for all Americans, especially those in historically marginalized communities who experience racism and discrimination, one's zip code should not impair health and well-being.
- Differences in opportunities and resources in our communities, in access to care, and in the quality of care received lead to health disparities and must be eliminated.
- Social, physical, economic, political, and environmental factors shape every aspect of our lives.
- The immediate goal is to protect the safety net and ensure safe, affordable, high-quality, culturally responsive care, and to support the conditions in neighborhoods that provide resources and protective factors that contribute to total health and well-being.
- Ultimately, universal health care will save the most lives and ensure that all people, including marginalized groups, can live whole and healthier lives.
Priority Policy Solutions
Keep Health Coverage Affordable
Restore and protect the ACA tax credits that make health care affordable for millions of Americans and their families.
Strengthen Medicaid, Protect Vulnerable Lives
Reverse the Medicaid cuts, expand access, and strengthen this safety-net program that provides essential healthcare to millions of babies and children, pregnant people, seniors, people with disabilities, and those with mental and behavioral health conditions.
Equity Starts With Food Security
Fight food insecurity by fully funding the Supplemental Nutrition Assistance Program (SNAP) and the Women, Infants, and Children (WIC) program, and by creating equitable food systems.
Who Has the Power & How to Take Action
Learn how to maximize the change you create in your community.