This swing state is poised to make the GOP pay

In York County and Virginia Beach, a couple of 40-year-olds with two kids and a combined household income of $150,000 could see their health insurance premiums rise by $4,330 per year if the U.S. Senate and House fail to extend health insurance premium tax credits now set to expire on Dec. 31.

A similarly situated family in relatively affluent Albemarle County is looking at a yearly increase of $6,244 in premiums.

These estimates do not come from Democrats or Republicans. They come from a calculator prepared by KFF, the Kaiser Family Foundation, one of the country’s most reputable health policy organizations.

Experts predict that huge premium increases to households that would lose expired premium tax credits could leave as many as 100,000 Virginians uninsured.

The cost of human suffering by those forced into bankruptcy due to illness or those who forego treatment because they cannot afford to pay is hard to calculate. What is certain is that the increased cost will devastate people of all political persuasions.

This begs the question of why none of Virginia’s Republicans in the House of Representatives would sign a discharge petition to force a vote on a bill to extend the tax credits for three years.

Four Republicans, three from Pennsylvania and one from New York, joined 214 Democrats to force debate on the bill this week, after House Speaker Mike Johnson refused to include premium tax credits in a Republican health-care reform proposal Wednesday. Johnson then abruptly ended a 204-203 House vote that blocked quick consideration of the discharge bill before Congress adjourns for the holiday season on Friday.

Conspicuously missing from the list of GOP members challenging Johnson were two representatives from the Old Dominion.

First Congressional District U.S. Rep. Rob Wittman, whose district includes York County, and Second Congressional District U.S. Rep. Jen Kiggans, whose district includes Virginia Beach, have each made, then broken, promises to go to the mat to control constituents’ health-care costs. Kiggans even co-sponsored a bill that would have extended health insurance premium tax credits for two years. It never came to a vote.

Wittman made no promise on premium tax credits. But like Kiggans, during federal budget negotiations he co-signed a letter to Johnson saying he would not vote for a federal budget that cut access to Medicaid, then, like Kiggans, did so twice.

Since then, Wittman and Kiggans have offered continuous pledges to make health care affordable. With their failure to support a discharge petition to force a vote on premium credits, they have once more betrayed constituents.

Both Republican incumbents risk losing their seats in Congress for ignoring constituents in health-care votes and for failing to hold President Donald Trump accountable for economic policies such as tariffs that have already raised the costs of goods and services for those they represent.

Since November’s Democratic sweep of statewide offices and increased control of both chambers of the state legislature, talk has focused on whether Virginia will redraw congressional districts to favor Democrats as a way to offset Trump’s command to Republican-run states to develop redistricting plans that increase the GOP’s congressional representation. But Wittman and Kiggans would still be in trouble if Virginia left their districts intact.

Health care expenses represent a bipartisan financial crisis. A May 2025 tracking poll by KFF showed “three-quarters of uninsured adults say they have skipped or postponed getting the health care they needed due to cost. Having health insurance, however, does not offer ironclad protection as about four in ten adults with insurance (37 percent) still report not getting health care they needed due to cost.”

Those are the stakes as the clock winds down on Congress’ failure to extend the premium tax credits, if only for a few years to work out kinks and help the middle and upper middle classes protect their families. Instead, Republicans just voted down a Democratic proposal for a three-year extension of premium tax credits in the Senate and refused to even bring it up in the House.

Johnson and other Republican leaders who control the Senate and House continue to hurt their own constituents, including essential middle class voters, in the name of partisan purity. Yes, health-care premium tax credits are a result of former Democratic President Joe Biden’s Inflation Reduction Act. Yes, those credits also pair with former Democratic President Barack Obama’s signature health-care reform bill, the Affordable Care Act (ACA). At this point, though, the Republican obsession with destroying the ACA has turned self-destructive.

A 2025 Virginia Joint Commission on Health Care report shows why. The state saw reductions in the number of residents without health insurance from 2018 to 2023 due to Medicaid expansion and growth in the Children’s Health Insurance Program (CHIP).

Helping the middle and upper middle classes afford health insurance with tax credits makes for a healthier mix of incomes and individuals. Some Republicans contend this amounts to welfare for those who do not need it. Such criticism drips with hypocrisy coming from GOP majorities in the Senate and House, whose members — including Virginia’s entire Republican delegation — just voted for a federal budget without health premium tax credit extensions, but with permanent extensions of tax cuts for the country’s richest individuals and corporations.

Dumping premium credits also ignores the hidden cost of emergency room visits by the uninsured it creates. Those visits often go at least partially unpaid and eventually get passed on in the form of higher insurance premiums to those who do have health coverage. One daunting fact that emerged from Virginia’s 2025 health metrics report is that “the percentage of potentially avoidable emergency department visits in Virginia has steadily increased since 2021.”

As time runs out for extending health insurance premium credits, Republicans have offered little that will effectively replace them. As he did in his first administration, Trump has promoted cheap private health insurance policies that do not cover prior existing conditions, have monetary caps on services, and/or require large deductibles before benefits kick in.

Republicans in Virginia, including Wittman, talk about privatization of health care. Often that includes giving money to individuals for health savings accounts that can be used to buy their own insurance policies or other uses. But the subsidies Republican plans mention — $1,000 per year for some people and $1,500 for others – would not be enough to pay the costs of a couple of trips to the emergency room, much less the bill for a single in-patient surgery.

The Senate and House need to extend the health insurance premium tax credits at least temporarily, if for no other reason than this: They sustain Americans’ physical and financial health in a country where for-profit medical services enrich everyone except the patients.

Virginia’s Republican delegation to Congress forgets that at its own peril.

• Virginia native Jim Spencer is a former Minnesota Star Tribune Washington correspondent, metro columnist for the Denver Post and the Newport News Daily Press, feature writer for the Chicago Tribune, editorial page editor for the Charlottesville Daily Progress, and reporter for the Norfolk Virginian-Pilot. He lives in Williamsburg where he started his 50-year journalism career doing a little bit of everything with the Virginia Gazette.