The help just ended.
The bill didn't.
West Virginia already pays the highest health insurance premiums in the country. At the end of 2025, Congress let the tax credits that made them affordable expire. Here's what that means for us, and why most Americans already agree it needs fixing.
Your premium just doubled.
What one Randolph County Marketplace plan now costs each month, after Congress let the enhanced tax credits expire at the end of 2025. Same coverage. That's about $1,668 more a year.
Why: the enhanced tax credits expired. Source: KFF, 2025 →Nothing about your health changed. The help did. The same plan, the same doctor, the same family, now costs about twice as much because a credit was allowed to lapse. That wasn't the weather. Someone voted for it.
We had the most to lose.
West Virginia has the nation's highest full-price premiums, so 89% of marketplace enrollees leaned on tax credits, the biggest average subsidy in America.
Source: KFF, 2025 →The drop in West Virginia marketplace sign-ups for 2026, the first full year without the enhanced credits. People are already getting priced out.
Source: healthinsurance.org, 2026 →West Virginians set to lose Medicaid under the 2025 federal budget law, in a state where more than 510,000 people rely on it.
Source: Mountain State Spotlight, Aug. 2025 →West Virginia's uninsured rate in 2024, near the lowest ever after Medicaid expansion and ACA coverage. That's the progress now at risk.
Source: healthinsurance.org, 2026 →We made them cover black lung.
West Virginians didn't wait on the market to look after their health. In February 1969, coal miners walked off the job over black lung, the disease that was drowning them from the inside while the law refused to call it a disease at all. It started at one mine and spread. By early March roughly 45,000 miners were on strike, shutting down the coalfields and marching on Charleston.
It worked. On March 11, 1969, the governor signed the first state law in the country to recognize black lung for workers' compensation. That same year Congress passed the federal Coal Mine Health and Safety Act, with black lung benefits and the strictest coal dust limits in the world.
Ordinary West Virginians decided health care was worth fighting for, and they won. We can do this.
Two out of three of us already agree
66% of Americans say the federal government should make sure everyone has health care coverage, including 41% of Republicans and 90% of Democrats. This isn't a fringe position. It's where most people land.
Congress decides whether the tax credits come back and how deep the Medicaid cuts go: that's your two U.S. Senators and your Congressman. In Charleston, state delegates and senators write the Medicaid budget and set PEIA for public workers. Every one of those seats is on a ballot you fill out. Most Randolph County races are settled by a few hundred votes.
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Every fact here is verifiable
- KFF : ACA marketplace premium payments would more than double if enhanced tax credits expire (2025)
- KFF : What we know so far about 2026 ACA marketplace enrollment, premiums, and deductibles (2025)
- healthinsurance.org : West Virginia health insurance marketplace, 2026 ACA coverage guide
- Mountain State Spotlight : Nearly 55,000 West Virginians are set to lose Medicaid (Aug. 2025)
- Pew Research Center : Most Americans say government has a responsibility to ensure health care coverage (Dec. 2025)
- Zinn Education Project : The 1969 wildcat black lung strikes
- West Virginia Encyclopedia : Coal Mine Health and Safety legislation