Report outlines consequences to individuals and the state if enhanced premium tax credits are allowed to expire at the end of 2025.

COLUMBIA, S.C. (May 28, 2025) – The South Carolina Institute of Medicine and Public Health (IMPH), a nonpartisan, nonprofit organization working to collectively inform policy to improve health and health care in South Carolina, has released a new report, Consequences of Ending Affordable Care Act Enhanced Premium Tax Credits in South Carolina. This report outlines the economic and health consequences to the state if Congress allows the expiration of the tax credits that help people afford their premiums.

In South Carolina, approximately 571,000 people purchase their health insurance through the Affordable Care Act (ACA) Marketplace, a number that is projected to rise to over 600,000 by the end of 2025. Ninety-five percent of those people receive a premium tax credit that makes their Marketplace plan more affordable.

“This report highlights the significant role the premium tax credits play in supporting health coverage and the broader health care system in South Carolina,” says Maya Pack, executive director of IMPH. “Data demonstrates that thousands of people would lose coverage, increasing the financial strain on hospitals — especially in rural areas.”

The report addresses both public health and economic consequences to the state, such as estimated loss of insurance coverage by individuals and families, the cost of uninsured care to the state, and the effect on rural hospitals, among others. South Carolina is projected to lose $2.2 billion per year in federal subsidies and incur over $900 million in costs attributed to uninsured patients. The report provides data on the state, county and congressional district level.

The work of IMPH is funded by a diverse array of public and private sources. This report was produced with support from Absolute Total Care and the South Carolina Primary Health Care Association.

About IMPH

The South Carolina Institute of Medicine and Public Health (IMPH) is an independent, nonprofit organization working to collectively inform policy to improve health and health care in South Carolina. IMPH provides nonpartisan, evidence-based information to guide policymakers in making impactful health policy decisions. Learn more at imph.org.

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