Christine Meehan: Racing Against the Deadline to Lose Premium Tax Credits

Christine Meehan, 51, has worked as a hairstylist in Pennsylvania for over three decades. Because she does not receive insurance through her employer, she relies on coverage through Pennie, the state’s health insurance Marketplace, and premium tax credits that help her afford that coverage.

Even though Christine works full-time, her income is based entirely on commission, making it unpredictable. “Every week’s different. I can make $400 a week; I can make $800 a week,” she said. Her income places her just above the Medicaid eligibility threshold, putting her in a difficult position shared by many in the lower middle class, earning too much for public assistance but not enough to afford the basics, including health care.

Her silver-level plan, even with a subsidy, remains expensive and limited. “I had to go down this year because the premiums went up.” Her monthly premium is $160, but co-pays and deductibles add up fast. “It was $30 to go to a doctor, now it’s $50. The specialist is $100.”

To reduce her premium, Christine estimated a lower income, only to owe money at tax time. “They took my entire tax return and I still owed an additional $500.”

Without the tax credit, Christine’s plan would cost approximately $580 a month. If Congress were to let these credits expire at the end of this year, Christine would have to go without insurance. “If I lose this subsidy, I can’t do $500 or more a month. So, I’m out.”

Christine feels as though the system penalizes people like her. “I never milked the system, never tried to get anything for free,” she said. “I feel like I never got help for anything. The subsidy was great because I’m like, oh finally, something for somebody like me.” She even noted that she hasn’t taken a vacation in over 20 years, “I don’t take a day off ever.  I can’t afford to.”

Before these tax credits, Christine made the risky decision to go years without insurance. “Luckily, I was young enough that I didn’t have any major problems. But now that I’m 51, I do.” She lives with high blood pressure and a neck condition that may require surgery. The deductible for the procedure is $7,500. For now, she’s managing the pain with $1,500 epidural injections, paid out of pocket. A temporary fix, but not a sustainable one.

Christine’s fiancé has employer-based coverage but putting her on his plan would cost over $600 a month, which is unrealistic for their budget. She explored private options with a broker, but without a subsidy, nothing is affordable.

As the deadline for extending premium tax credits approaches, Christine is rushing to schedule essential care in case she has to go without coverage. “I’m trying to schedule all my stuff in case.”

Christine wants her lawmakers to know, “This lower middle class working person, we just simply can’t afford it. I’m out of options.”