WASHINGTON — Roughly 170,000 Alabamians could lose health insurance under President Donald Trump’s budget bill, and advocates worry this could have a ripple effect on the state’s health care system.

The U.S. House passed sweeping federal legislation before Memorial Day that seeks to make major changes to Medicaid. The bill will now move through the Senate .

Since Alabama has not expanded Medicaid, one of the biggest impacts of the bill in the state could be that the legislation does not extend the Affordable Care Act’s enhanced premium tax credits, which are set to expire at the end of the year. Congress expanded eligibility for the credits in 2021.

The credits help make health insurance more affordable on the marketplace. Premium costs for enrollees are expected to rise without an ex

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