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Defending Health Care

Protecting Health Care

Make no mistake, threats to families’ health coverage and care are still very real. Sadly, there are parties who will stop at nothing to take away health care and destroy the quality of health insurance through regulatory actions, cuts to Medicaid, restrictions to Medicaid, or outright repeal of the health care law. Whenever you have the opportunity to communicate with your members of Congress, it’s important to remind them that you will hold them accountable for any action they take that damages our ability to get or afford high-quality health care.

Threats to Health Care

Legislative threats

The Affordable Care Act (ACA) has faced numerous threats and challenges since 2010, and Families USA has worked as a continued champion of affordable and comprehensive coverage for all, organizing sign-on letters to Congress, testifying, writing issue briefs, and lifting up how people would be affected by various actions. Threats range from eliminating coverage of vital services, to discriminating against people with preexisting conditions, to taking away coverage all together.

In 2024, nearly 20 million people across the country get help paying for their health coverage through advance premium tax credits (APTCs), which can help them to pay for health insurance premiums for plans purchased through the Marketplace. These credits are an affordability lifeline to make it easier for individuals and families to access coverage and care. If Congress does not act, this assistance will be reduced and millions of people may become uninsured, skipping needed health care, or taking on medical debt from which they can never recover. Under the American Rescue Plan Act (ARPA) Congress expanded APTCs, and further extended this under the Inflation Reduction Act (IRA) to temporarily lower premiums for Marketplace health plans, reducing overall health costs for people at income levels above and below the federal poverty level (FPL). But, these are set to expire at the end of 2025, leaving people at risk of significant losses. Solutions like APTCs are critical to ensure that families have access to affordable health care options. It is key for Congress to work to permanently extend these health care affordability lifelines.

Families USA continues to advocate for, and protect Medicaid in the face of relentless opposition seeking to undermine the program. Despite concerted efforts to cut funding, restrict eligibility, and dismantle its core principles, Families USA remains steadfast in our commitment to defend Medicaid as a cornerstone of our healthcare system. Cuts would cause people to lose access to services they use and depend on every day. They would worsen care for older adults and people with disabilities, leave numerous families and individuals without health care all together or face insurmountable medical debt, and force hospital to close. And for many families, Medicaid provides the only affordable access to vital medical care, including oral health care and substance use treatment.

Legal threats

The ACA requires a wide array of services to be covered by private health insurance plans with no additional cost-sharing, like a copay, ensuring that preventative services won’t dent your budget. However, the ACA has faced several legal challenges from groups and individuals trying to remove these protections and benefits. One such case that Families USA is following as it makes its way through the courts, is Braidwood Management, Inc. et al. v. Xavier Becerra et al. In a pivotal 2023 decision, Judge Reed O’Connor ruled in favor of Braidwood, making it possible for private insurance providers to refuse certain preventative services on religious or moral grounds, and sparking an appeal by the Department of Justice (DOJ). The case is on appeal, and the outcome could dramatically alter the U.S. health care landscape.

Want to know more? Check out (and share!) our brief explainer videos below.

Regulatory victories

Families USA actively comments on proposed regulations and calls attention to problems people experience that regulators should address. Recent successes include: a landmark lawsuit from the Federal Trade Commission (FTC) cracking down on fraudulent health plans and deceptive marketing; regulations and oversight to clamp down on junk short-term plans and association health plans that do not protect people with health conditions and mislead people; rules to prevent discrimination in health care; and requirements for strong outreach to people nearing the end of Medicaid recertification periods to preserve benefits for people who are eligible.


Guide to meeting directly with your member of Congress: Face-to-face meetings with your representative or senators are among the most powerful ways to educate them about how proposed legislation will affect you.

This guide outlines how to make meetings happen and how to make them effective.

Medicaid Matters — Share resources about why we need to retain all important Medicaid coverage.

Defending Health Care in 2017: Archive of our successful efforts to stop Congress from repealing the health law in 2017.

Defending Health Care from 2019 to 2023: Archive of our successful efforts from 2019 to 2023.

Mary Wanalo, Illinois

A gynecological surgery meant that Mary Wanalo, 55, would be denied insurance based on a preexisting... read more