Kansas cancer survivor fears for health care as Congress weighs premium tax credit extension
Dawn Wheeler of Edwardsville speaks during a virtual news conference on Sep. 30, 2025, about how the potential expiration of enhanced premium tax credits could impact her cancer treatment. (Kansas Reflector screen capture)
TOPEKA — Dawn Wheeler, a small business owner in Edwardsville, receives treatment for her metastatic breast cancer almost weekly.
One shot, which she gets every other week to treat cancer in her liver, costs around $10,000, she said.
“That doesn’t include all the doctor visits, all the regular testing I have to have, two other chemo pills I have to have, all of which I would not be able to afford if I did not have the ACA,” Wheeler said Tuesday during a virtual press call organized by U.S. Rep. Sharice Davids, a Kansas Democrat.
Wheeler is one of more than 187,000 Kansans who rely on Affordable Care Act premium tax credits to subsidize health care costs, but those credits are set to expire at the end of the year, and advocates are warning of lost coverage and a more than 75% spike in premium costs as they wait for lawmakers to decide the credits’ fate.
Unless Congress extends the tax credits, health care costs for the more than 22 million Americans who have health insurance through the ACA Marketplace are expected to increase, and community hospitals could bear the burden of uncompensated care. In Kansas, the vast majority of the more than 200,000 people enrolled in the marketplace receive premium tax credits, according to data from KFF, a nonprofit health policy research and news organization.
Cindy Samuelson, senior vice president of member and public relations for the Kansas Hospital Association, said on the call that hospitals have made it clear that premium tax credits have played a key role in reducing the number of uninsured patients in Kansas and across the country.
On average, enrollees’ annual premium costs could increase by an estimated $700, or 77%, if the tax credits are not extended. Samuelson said. Projections from KFF estimate that between 48,000 and 61,000 Kansans could lose coverage because of higher premium costs over the next decade. An estimate from the Hutchinson-based United Methodist Health Ministry Fund projects 108,000 Kansans losing coverage over the same time frame.
“The reality is, when someone doesn’t have health insurance, we know that they are more likely to stop taking care of themselves,” Samuelson said.
People are more likely to halt preventative health care services, and people with chronic conditions are more likely to delay health care, waiting until their health worsens and they end up in an emergency room, which is often the most expensive kind of care, Samuelson said.
Wheeler, who owns a health screening business with her husband, said she doesn’t know what they would do without ACA coverage.
“I honestly don’t think I’d be alive,” she said. “I know we wouldn’t have a house anymore. That’s the reality of it.”
Davids said she supports a permanent extension to the tax credits. In her district, which represents 4½ counties in and around the Kansas City area, she said a family of four could see a $7,000 increase in their premiums. A 60-year-old couple could see a nearly $17,000 increase, she said.
“If we don’t act, the ripple effect of this increase will be devastating,” Davids said.
She said she is willing to work with either party to pass a feasible extension.
“We are also staring down another challenge that, unfortunately, we’ve become too familiar with, which is a potential government shutdown,” Davids said.
Congress has until midnight Tuesday to avoid a government shutdown, which could impact Kansas’ nearly 20,000 federal employees and active-duty service members, as well as access to federal services.