When Politics Meets Pediatrics: Why Advance Premium Tax Credits Matter

By Annette Logan-Parker Founder & Chief Advocacy & Innovation Officer, Cure 4 The Kids Foundation

As Congress races toward another government funding deadline, much of the debate in Washington may sound abstract: appropriations, budget caps, and partisan negotiations. But for the families we serve at Cure 4 The Kids Foundation, the consequences are anything but abstract.

One of the most immediate risks of a shutdown is the potential disruption of Advance Premium Tax Credits (APTCs) — the monthly subsidies that make marketplace health insurance affordable for millions of Americans.

Why APTCs Matter for Families Facing Childhood Cancer and Rare Diseases

Many of the families we care for are caught in the “in-between.” They earn too much to qualify for Medicaid, but not enough to afford full-price health insurance premiums. For them, the APTC is what makes continuous coverage possible.

Without it, premiums can rise by hundreds of dollars each month. For a family already facing the emotional and financial toll of a pediatric cancer or rare disease diagnosis, that increase can be devastating. Even a short lapse in coverage risks:

• Delayed chemotherapy or infusion therapy
• Exclusion from clinical trials funded by the Children’s Oncology Group
• Catastrophic out-of-pocket costs that no family can shoulder alone

At Cure 4 The Kids Foundation, we treat every child, regardless of their insurance status or ability to pay. But when subsidies lapse, the cost doesn’t go away — it shifts. It lands on families least able to absorb it, on nonprofit providers like ours already providing millions in charity care each year, and ultimately on state Medicaid systems and taxpayers.

The Policy Debate: Two Perspectives

What’s important to understand is that both political parties care about access and sustainability — but they approach the problem from different angles.

• Democrats view APTCs as a cornerstone of the Affordable Care Act. They have worked to expand subsidies through legislation like the American Rescue Plan and Inflation Reduction Act, arguing that uninterrupted coverage is essential for equity, continuity of care, and reducing the number of uninsured Americans.
• Republicans often view APTCs as an expensive federal entitlement that distorts the private insurance market. They raise legitimate concerns about long-term cost, dependency on subsidies, and the need for state-level flexibility in designing insurance solutions.

Both perspectives matter. Democrats remind us that coverage gaps can be life-threatening. Republicans remind us that systems must be financially sustainable.

Where We Must Find Common Ground

For children in active cancer treatment, this is not a partisan issue. Coverage cannot simply be paused or delayed while Washington debates policy. A chemotherapy infusion missed due to a lapse in coverage is not just a financial inconvenience — it can alter a child’s chance at survival.

That is why we urge leaders on both sides to recognize the reality:

• Lapses don’t save money. They shift costs to families, nonprofits, Medicaid programs, and ultimately taxpayers.
• Coverage stability is more efficient. Continuous care in outpatient settings is far less costly than delayed or emergency interventions when coverage lapses.
• Children cannot wait. Their treatment timelines are measured in days and weeks, not fiscal quarters.

A Call to Bipartisan Action

At Cure 4 The Kids Foundation, we have always stepped in where systems fall short — from building Nevada’s only nonprofit pediatric cancer and rare disease center, to creating a Charity Care Program that ensures no child is ever turned away.

But nonprofits cannot be the permanent backstop for policy gaps. This is where federal leadership is vital.

We call on Congress to approach the Advance Premium Tax Credit debate not as a partisan wedge, but as a bipartisan opportunity to protect families, prevent downstream costs, and ensure children in the middle of treatment are not collateral damage in a budget standoff.

Because when politics meets pediatrics, the stakes are too high for anything less than cooperation.

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