Ellen Allen: A Health Care Advocate Navigating Coverage Through the ACA

Ellen Allen, a resident of Pinch, West Virginia, is the Executive Director of West Virginians for Affordable Health Care, a nonprofit advocating for accessible and affordable health care across the state. She is also a mother to an adult with disabilities. Ellen’s organization is too small to offer a health insurance plan, so she turned to the Affordable Care Act (ACA) to meet her own health care needs.

Two years ago, Ellen enrolled in a health insurance plan through the ACA marketplace, and a record number of over 65,000 other West Virginians enrolled alongside her this year. She currently receives $1,400 per month in Enhanced Premium Tax Credits. While she still pays part of her premium, the tax credit goes directly to the insurance company and allows her to set aside funds for other costs.

“It’s the enhanced premium tax credits that make the Affordable Care Act truly affordable,” Ellen said. “That saves me $1,400 a month that I can set aside for out-of-pocket costs and co-pays. That’s true peace of mind.”

However, these enhanced tax credits are set to expire at the end of the year. Without them, Ellen’s health insurance costs could skyrocket, along with more than 20 million other Americans. Right now, the average premium cost for marketplace health insurance plans is $179 with the tax credits, but without the credits, the average cost balloons to $636.

“I have calculated I have to set aside between $35,000 and $40,000 next year just to cover my health care costs,” Ellen said. It’s a burden she knows many West Virginians simply cannot afford. If people like Ellen can’t pay those extra costs, they will be forced to delay or skip crucial health care services.

While Ellen considers herself “one of the lucky ones” that may be able to hold onto her insurance, she stresses that over 51,000 West Virginians could lose access to affordable care if these credits expire.

Update:

As of 2026, Ellen has already felt the full force of the enhanced Premium Tax Credits expiring. Her monthly premium jumped a staggering 323% — from $479.84 per month in 2025 to $1,965.87 per month in 2026. And that’s for a worse plan: she was forced to drop her vision and dental coverage entirely, which she could no longer afford. “When I saw my new premium for 2026, I felt a pit in my stomach,” she said. “It was a punch in the gut.” Her maximum out-of-pocket costs also increased, and with chronic conditions that require ongoing management, she expects to hit that cap. Before she becomes eligible for Medicare in September, she anticipates paying $15,726.96 in premiums alone, with total health care expenses projected to reach approximately $25,626 in just the first eight months of the year. To cover those costs, she has had to dip into her retirement savings.

Ellen is clear-eyed about what this moment represents. “The expiration of the ePTCs was not an economic inevitability,” she said. “It was a political choice.” She knows others in her state are making even harder choices, dropping coverage altogether and hoping they don’t get sick or have an accident that could bankrupt them. As someone who has worked every day of her teen and adult life, Ellen is calling on Congress to act. “Health care is not a luxury, it is a necessity. The ability to access it should never depend on how much money you make, where you work, or who you voted for.”