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Dr. Tom Dancoes is the medical director of emergency medicine at Houlton Regional Hospital.
As a Mainer and an emergency medicine physician in Houlton, I am worried that many of my neighbors and patients could lose access to health care. I often find myself more than just a health care provider to my patients. In a small community like this, you are also a friend and sometimes even a sounding board for the challenges people face beyond their health.
I have learned that health care isn’t just about treating illnesses, it’s about understanding the lives of your patients, the hurdles they face, and the deep impact that those challenges can have on their well-being. One of the most significant hurdles I see every day is the cost of health insurance.
The reality is that even as every dollar is stretched at the grocery store, many of my patients are facing difficult choices when it comes to their health. Some patients, particularly those with lower incomes or jobs that don’t provide health coverage, are forced to choose between paying for insurance and covering other essential needs like rent or utilities. These decisions are not only financial, but they also have real health consequences.
Nearly every day I care for patients with severe and life-threatening illnesses that result from delayed care. When people can’t afford health insurance, they delay preventive care and ultimately end up with more severe health issues that could have been avoided or managed earlier. The cycle continues, often with devastating consequences for both individuals and families.
That’s where the Enhanced Premium Tax Credit comes in. This policy has been a lifesaver for many Mainers, especially those in communities like Houlton. The tax credit makes health insurance more affordable by lowering premiums for individuals purchasing coverage through the Health Insurance Marketplace, also known as CoverME. In practical terms, it means that for many families who were previously priced out of the market, affordable health insurance is now within reach.
Of the 31,000 people living in Maine’s Second Congressional District who purchased quality, comprehensive health insurance coverage through CoverME in 2024, 26,000 receive these tax credits to help lower their monthly premiums and make health care more affordable. For patients like mine, the enhanced premium tax credit has made all the difference.
Before this subsidy, I heard stories about the struggle to find an affordable plan, and for years, many went without insurance, just hoping and praying that nothing went wrong. But with the help of the premium tax credit, plans were finally available that fit a working family’s budget. Their premiums are now lower, and they have the peace of mind that comes with knowing their family is covered in case of illness or injury. They are also less likely to delay the care that they need.
But the benefits of the premium tax credit do not end with individuals. Maine has also taken bold steps to help small businesses by allowing them access to this tax credit. This has helped reduce health care costs for small businesses, many of which have been struggling to offer affordable health insurance to their employees for years. As a result, small business owners across the state can now provide more affordable insurance options to their employees making it easier for them to attract and retain workers, while also keeping their health care costs under control.
By making insurance more affordable, the tax credit allows people to seek out preventive care, manage chronic conditions, and address health issues before they become emergencies. This not only improves the quality of life for individuals, but it also helps reduce long-term health care costs for the community.
Despite the progress we’ve made, we can’t take these improvements for granted. The cost of health care is still a significant burden for many families and employers, and the need for affordable health insurance remains critical. The enhanced tax credits are set to expire at the end of 2025. Congress needs to make the expanded tax credits permanent. If Congress does not act to protect the tax credits by the end of this year, a family of four here in Maine could see their annual premiums increase by $7,963. This increase would be devastating for many, especially in rural areas where families are already stretched thin.
Now is the time for action. Our members of Congress must fight for the extension of these vital programs so that Mainers can continue to access the care they need without the crushing financial burden. Let’s make sure that affordable health care remains a reality for everyone, no matter where they live.
