Mother of Two Medically Complex Children and Small Business Owner, Uses Enhanced Premium Tax Credits to Keep Her Covered

Shayela Ankenbauer is not your typical mother. As the co-owner of a tattoo shop in Lafayette, Tennessee, and the mother of twin boys with complex medical needs, Shayela understands what it means to juggle work, parenting, and the high cost of healthcare. For her and her husband, affordable coverage through the Marketplace—made possible by the Enhanced Premium Tax Credits (EPTCs)—is the only thing that keeps her insured.

“Before getting on the Marketplace, we didn’t have insurance,” Shayela explained. “When I was pregnant with my boys ... I had to see several specialists, and with those specialists the monthly payment of the insurance [on Marketplace] helped cover those visits.”

Shayela and her husband now both work full-time running their shop and rely on Marketplace coverage to cover their health insurance while they focus on the needs of their children: “It definitely has helped,” she said. “My boys are medically complex: one has cerebral palsy, and the other has other medical problems. With them being covered by TennCare, being on the Marketplace gave us something we don’t have to worry about with all the worries we have with them.”

Affordable coverage has been life-changing for Shayela. She has been able to stay on her medications for blood pressure and depression, care she says she would have skipped without the Marketplace plan: “If I didn’t have the EPTC, I wouldn’t go to the doctor because I wouldn’t have insurance,” she said.

But like many Tennesseans, she worries about what could happen when the Enhanced Premium Tax Credits expire at the end of 2025. “[I] probably would not have insurance,” she said. “We can afford it now, and that’s the only reason we have it. I prioritize my boys over myself.”

The Tennessee Justice Center hears stories of hardworking families like Shayela’s every day. They do everything right but are still caught between the high costs of healthcare and the realities of raising children, managing small businesses, or caring for loved ones with medical needs.

The Enhanced Premium Tax Credits have given thousands of Tennesseans peace of mind and access to affordable care. But unless Congress acts to extend these savings, that progress will vanish, and families like the Ankenbauers will once again face impossible choices between health and financial security. For Shayela, the choice is clear. “We’re just trying to take care of our boys,” she said. “These savings help make that possible.”