Guest Opinion

A cancer survivor and nonprofit director highlights the importance of the enhanced health care tax credit for affordable insurance coverage.

Expiration of the tax credit could drastically increase health insurance premiums for millions of Americans, including those with chronic conditions.

Congress is urged to extend the credit to prevent unaffordable healthcare costs and protect vulnerable families.

Like many Americans, I spent most of my adult life focused on working hard, taking care of my family, and paying the bills. I was an ultra-endurance athlete and coach. I took care of my health.

But on Jan. 15, 2015, at age 43, with three kids aged 12, 9, and 1 1/2, I was diagnosed with multiple myeloma, a blood cancer that came with gruesome symptoms and a long-term prognosis. I went from Superman to patient before I even knew how to spell my disease.

Cancer treatment isn’t as simple as showing up for infusions and waiting for life-saving magic to work. Someone has to pay for it. Without insurance, my first year of treatment would have cost nearly $700,000.

Three days after my diagnosis, I was able to purchase coverage through the health insurance marketplace — coverage I’ve relied on ever since. I’m grateful to still be here, but my condition requires constant monitoring, testing, and ongoing care to keep the cancer at bay. That’s likely to be the case for the rest of my life.

Even with insurance, the cost of care has taken a serious bite out of our family budget. Medical travel, co-pays, lab work, and medication all add up. Thankfully, in 2021, Congress increased the value of the health care tax credit, making coverage much more affordable for people like me. It’s been a lifeline, one that has literally helped me stay alive and present for my family.

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But that tax credit is set to expire at the end of this year. Through proposed legislation, some lawmakers are suggesting that letting the Enhanced Premium Tax Credit expire is a good thing. And Congress has yet to act. If lawmakers don’t extend it, premiums will skyrocket — including mine — and many of us will have to make dramatic decisions affecting our health and longevity.

I live in Black Mountain, North Carolina, and I direct a small nonprofit. I’m not wealthy. I fall in the gap where I earn too much to qualify for Medicaid, but not enough to comfortably afford private insurance without help. If the tax credit disappears, my monthly premiums could more than double, easily exceeding our mortgage. That would force hard decisions, cutting into basic household expenses and possibly putting some of my treatment out of reach.

And I’m not alone. In fact, I’m not in any of the groups most at risk.

Over 24 million Americans are enrolled in marketplace coverage, and almost all of them receive the tax credit. If it’s allowed to expire, 1.7 million people with chronic health conditions could lose their coverage entirely.

In North Carolina alone, nearly 1 million people received the tax credit in 2024. If it ends, a family of four making $64,000 could see their premiums increase by more than $2,500 a year. A family earning $124,000 might pay $9,000 more. A couple nearing retirement could face an overwhelming $19,000 annual increase.

These numbers are more than statistics — they represent real people. Rural families, small business owners, and middle-income earners will be hit especially hard. And for cancer patients like me, this isn’t just about economics — it’s about staying alive.

If Congress doesn’t act, the situation will become dire for millions of us.

Sen. Thom Tillis and others have said they’re open to extending the tax credit, but so far, no action has been taken. The clock is ticking, and families like mine are left in limbo, waiting, hoping, and preparing for decisions no one should have to make.

The health care tax credit has made life possible for me. My cancer journey started more than a decade ago, and I wasn’t sure I’d live to see my kids graduate. But because of this coverage, I’m still here. I still get to be their dad. I still get to work, serve my community, and try to give back.

If the credit expires, I’ll be forced to consider how my family might live without me.

Health insurance doesn’t just make life easier — it makes life possible. Congress must act now to extend the health care tax credit and protect families like mine from impossible choices.

Kenny Capps is a writer, speaker, fitness coach, and executive director of Cancer Active Inc., a nonprofit whose mission is to educate and advocate for individuals living with cancer to improve their quality of life through healthy and active lifestyles monitored and assessed with CAPP, the Cancer Active Patient Portal and at becanceractive.org