How Congress Can Protect Families From Dangerous Heat and Ensure Cool and Healthy Homes for All

Summer 2024 shattered¹ global heat records for the second straight year, scorching² communities across the country and nearly guaranteeing³ that 2024 will be the hottest year on record. Phoenix endured another brutal summer of record-breaking heat, with 113 consecutive days⁴ of 100 degrees or higher temperatures, while unrelenting heat baked communities⁵across the West Coast, Southwest, Gulf Coast, Midwest, and East Coast.⁶ Historic heat waves continued into October in at least 125 places in the West, exposing millions of people to dangerously high fall temperatures.⁷

This was not an anomaly but part of a steady and alarming trend of rising temperatures fueled by climate change. In fact, the 10 warmest years on record have all occurred in the past decade (2014–2023).⁸ Extreme heat causes more death and injury⁹ in the United States than any other weather event, and in most years, it kills more people than floods, tornadoes, and hurricanes combined.¹⁰ Moreover, extreme heat is becoming more dangerous¹¹ every year as climate change¹² fuels longer and more frequent and intense heat,¹³ causing a steady increase¹⁴ in heat-related deaths and adding $1 billion in health care costs each summer.¹⁵

According to the U.S. Centers for Disease Control and Prevention, extreme heat killed more than 2,300 people¹⁶ in the United States in 2023, although experts estimate that the actual annual heat death toll is much higher than what has been recorded.¹⁷ A new study published in the Journal of the American Medical Association revealed that more than 21,518 people died from heat in the United States from 1999 to 2023, with the highest number of deaths in California, Arizona, Nevada, and Texas.¹⁸ The study found that heat-related deaths have more than doubled in the past 24 years, with the most dramatic increase occurring since 2016.¹⁹

The risk of heat-related illness and death is particularly high for those who don’t have air conditioning (AC) or cannot afford to run it, and that risk is escalating with climate change.²⁰ Not having AC when temperatures soar is not just a discomfort; it can be deadly. In 2023, 156 out of 645 (24 percent) heat-related deaths²¹ in Maricopa County, Arizona, took place indoors. In 94 percent of those cases, there was no AC, most often because it was broken.²²

Nationwide, 11 percent of households—14 million—do not have AC, and many are in regions with above-average temperatures.²³ People of color and low-income individuals are less likely to have AC than their white and wealthier counterparts (see Figure 1), and they are more exposed to high temperatures because of decades of racist policies such as redlining, putting them in greater danger of heat-related illness and death.²⁴ Data from the Energy Information Administration’s Residential Energy Consumption Survey (RECS) shows that nearly 6.4 million U.S. households had AC equipment they couldn’t use because they could not afford needed repairs or the energy bills, and more than three-quarters of these households made less than $60,000 annually. (see Figure 1) An analysis of RECS data by the National Energy Assistance Directors’ Association (NEADA) shows that nearly 20 percent of low-income households making less than $19,999 per year have no cooling equipment present at all, compared with 7 percent of households earning high incomes.²⁵

As climate change brings hotter, longer, and more frequent heat waves to communities across the country, extreme heat is becoming more dangerous for families that lack AC. The absence of home cooling when temperatures skyrocket is especially risky for older adults, pregnant people, infants, children, and other vulnerable populations.²⁶ Households in cooler-weather states, such as Washington and Oregon, that may not have needed AC in the past now face higher temperatures and rising heat risks in the summer without cooling systems in place.²⁷

Despite the growing need, Congress allocates fewer resources for low-income households in warm-weather states to pay energy bills for cooling and home weatherization.²⁸ For example, federal funding for programs such as the Low Income Home Energy Assistance Program (LIHEAP) provides essential support for households that struggle to pay their heating bills but has not kept up with rising temperatures and household cooling needs.²⁹ According to NEADA, federal funds for LIHEAP were cut from $6.1 billion in fiscal year 2023 to $4.1 billion in fiscal year 2024, with severe impacts on energy affordability across the country. As such, the number of households served by the program has dropped, and utility shutoffs for households unable to pay their energy bills have increased. Without adequate funds to help families meet their heating and cooling needs throughout the year, roughly 80 percent of program funds are used for heating during the winter, leaving only 20 percent to support cooling during hot summer months.³⁰

In August, the Biden-Harris administration released a National Heat Strategy to coordinate agency actions to protect communities from more extreme heat.³¹ The strategy rightfully calls on the federal government to “encourage technological development and adoption of energy-efficient cooling systems such as heat pumps,” among other actions, but new resources are required to effectively implement the strategy. This report discusses the measures Congress and other policymakers should take to better protect households and communities from the risks of extreme heat.

Congress must provide the funds needed to lower household energy bills, and protect families from the rising health risks and costs of longer, more intense, and more frequent extreme heat events driven by climate change.³² Specifically, Congress and other federal policymakers should take the following actions to safeguard households and communities from extreme heat risks:

• Secure cool and healthy homes for all by investing in point-of-sale rebates for efficient and cost-effective heat pump AC targeted to low- and moderate-income (LMI) households.
• Invest in programs to help households save money on their energy bills, reduce production cost for high-efficiency heat pumps so they are widely available for cooling and heating, and lower extreme heat risks in schools and communities.
• Make extreme heat events eligible for disaster declarations and improve the accuracy of reported heat-related illness and death.

These recommendations are described in more detail below.

Congress should invest at least $10 billion in point-of-sale rebates for efficient and cost-effective heat pump AC targeted to LMI households to ensure cool and healthy homes for all.³³ These funds would help LMI families improve the health, safety, and livability of their homes during heat waves and cold snaps by eliminating the financial barrier that for too long has prevented households from securing access to AC.³⁴ In addition to cooling homes more efficiently and cost effectively than most AC in homes today—especially window units³⁵—heat pumps provide efficient heating in the winter.³⁶ Heat pumps also help cut carbon and local air pollution by allowing households to shift away from gas-fired heating and cooling systems, and they help reduce medical expenses and lost income from missed workdays tied to heat-related illness.³⁷

To reduce extreme heat risks for LMI households, Congress should create a Cool and Healthy Homes Program to accelerate and expand the delivery of heat pump rebates. The U.S. Department of Energy (DOE) could implement this program in conjunction with its Home Electrification and Appliance Rebates (HEAR) program,⁴¹ which is described below.

Ideally, the DOE would award Cool and Healthy Homes funds to states, territories, and Tribes through competitive grants, rather than using a formula, like the one the DOE’s State Energy Program (SEP) uses to provide annual formula grants to support state-led energy initiatives and improve energy affordabilty, primarily based on state population and energy consumption.⁴² Competitive grants would allow the DOE to award Cool and Healthy Homes grants that directly correspond with a state’s extreme heat risks and needs. For example, the DOE could award competitive grants based on a state’s climate zone; number and percentage of LMI and energy-insecure households; demand for cooling centers; and commitment to coordination with existing energy savings, electrification, and home repair programs and financing (for example, from green banks) to help families lower their energy costs so they can afford to use AC when they need it.⁴³

Fortunately, states, territories, and Tribes are already building the infrastructure needed to provide heat pump rebates to LMI families. To date, 51 states and territories have applied for DOE grants to design and launch programs that will help households save money on their energy bills through the Home Energy Rebates program for home electrification and efficiency improvements.⁴⁴ States, territories, and Tribes can leverage this program infrastructure to offer Cool and Healthy Homes heat pump rebates by, for example, using the same tools to determine income eligibility, track household rebate use to avoid potential fraud or misuse, and monitor and analyze program implementation for quality assurance.⁴⁵

To ensure that all households that need heat pumps for cooling and/or heating can access them, the DOE should implement the Cool and Healthy Homes rebates in close coordination with its HEAR program and the Weatherization Assistance Program (WAP), as well as the Department of Health and Human Services’ LIHEAP and the Department of Housing and Urban Development’s (HUD) Green and Resilient Retrofit Program (GRRP).⁴⁶ In addition, local governments should be permitted to submit their own competitive grant applications for Cool and Healthy Homes rebate funding, similar to the Climate Pollution Reduction Grants(CPRG) program,⁴⁷ to give cities the opportunity to lower heat risks for households, especially if states don’t apply for the rebate funding.

To effectively improve access to AC during dangerous heat events, Congress must also help lower electricity costs so that families struggling to pay their energy bills can afford to cool their homes in the summer and heat them in the winter. More than 30 million households are energy insecure—unable to meet their basic cooling, heating, and other energy needs—putting families at risk during extreme heat events.⁴⁸ Low-income and Black- and Hispanic-led households are more likely than white-, Asian-, and wealthier families to avoid using AC to keep their electricity bills from skyrocketing.⁴⁹

To help address this challenge, the Biden-Harris administration’s IRA invested nearly $9 billion in Home Energy Rebates to help low- and moderate-income families upgrade their homes, including $4.5 billion in Home Electrification and Appliance Rebates, with up to $14,000 in rebates per household.⁵⁸ The rebates will help households lower their energy costs, cut carbon and local pollution, and transition away from fossil fuel use. 

Unfortunately, Home Energy Rebates and other clean energy investments under the IRA may be halted⁵⁹ if the policy proposals under The Heritage Foundation’s Project 2025 are implemented.

While the IRA funding for Home Energy Rebates was a welcome investment,⁶¹unless additional federal funds are allocated, the rebates will help just 1 percent of families in need save money on their electricity bills.⁶² To address this funding gap so that families can afford to use AC to stay safe during dangerous heat, reduce production cost for high-efficiency heat pumps so they are widely available for cooling and heating, and help schools and communities lower extreme heat risks, Congress should make the following investments: 

1. Significantly expand federal investments in Home Energy Rebates to accelerate home electrification and appliance upgrades for LMI households.⁶³ Federal funding for home energy rebates, though historic, is expected to run out by the end of 2026, long before the 2031 funding authorization end date.⁶⁴ This will leave millions of U.S. households in need of home electrification and appliance upgrades.⁶⁵ As recommended by Rewiring America, Congress should invest an additional $50 billion in the Home Energy Rebates program through 2031 to help LMI households upgrade their appliances, electrify their homes, and save money on their electricity bills while attaining the pace needed to meet the goal of cutting U.S. greenhouse gas emissions by 50 percent to 52 percent by 2030 and achieving net-zero emissions by 2050.⁶⁶ The $10 billion for the Cool and Healthy Homes heat pump rebates recommended above could be part of this $50 billion investment. State energy programs implementing Home Energy Rebate funding should encourage households to make home envelope improvements⁶⁷—such as adding insulation, sealing, installing new windows, and repairing roofs—to further increase energy bill savings and help keep families safe, healthy, and comfortable year round. State energy programs should also leverage funds from other federal programs, such as WAP, LIHEAP, the GRRP, and the U.S. Environmental Protection Agency’s GGRF, to accelerate home electrification and appliance upgrades for LMI households.
2. Create tax incentives for manufacturers to increase U.S. production of high-efficiency heat pumps for cooling and heating. To help households keep their cooling and heating costs down and create good new jobs, Congress should provide incentives for manufacturing to increase domestic production of high-efficiency heat pumps so they are widely available to those who need them. Congress can do this by expanding the 45x advanced manufacturing production tax credit⁶⁸ to encourage manufacturers to increase U.S. production of high-efficiency residential and commercial heat pumps for cooling and heating, as well as heat pump water heaters and heat pump components.⁶⁹ By lowering heat pump production costs, the tax credit could encourage manufacturers to phase out production of traditional AC units, which only cool, in favor of producing heat pumps, which both heat and cool. The tax credits should reward production of ENERGY STAR-rated heat pumps that meet strong labor and environmental standards to protect both workers and communities.
3. Expand HUD’s GRRP funding and scope to support electrification and energy efficiency improvements for public and affordable housing, which would lower energy bills and improve indoor air quality for more households, as well as reduce carbon and local pollution.⁷⁰ The IRA invested more than $1 billion to support upgrades to privately owned and subsidized multifamily properties to improve their energy and water-use efficiency and strengthen their resilience to flooding, extreme heat, and other climate change effects.⁷¹ To date, HUD has awarded 97 percent of the IRA funds—$1.12 billion—to improve 225 properties and roughly 26,000 rental homes.⁷² Despite this progress, more funding is needed to improve the energy efficiency and climate resilience of additional multifamily properties that require upgrades.⁷³ Specifically, Congress should expand the funding and scope of the GRRP so that HUD can award grants to housing authorities to install high-efficiency heat pumps for cooling and heating. For insights on effective program design, HUD could look to the New York City Housing Authority, which is piloting a program to install window heat pump units in public housing apartments.⁷⁴ The units will provide heating and cooling for residents while reducing carbon pollution.
4. Make energy-efficient home improvement credits (25C)⁷⁵ refundable. This credit offers homeowners up to $3,200 in tax credits per year to reduce the cost of home energy efficiency upgrades, including purchasing heat pumps, by up to 30 percent. The 25C credit is currently nonrefundable, meaning that homeowners cannot receive more money on the credit than they owe in taxes; they also cannot apply any excess credit toward taxes owed in future years. Credit benefits are limited to those who pay taxes and can afford to pay the up-front cost of home improvements and then claim the credit when they file their tax returns, which benefits wealthier homeowners more than low-income households.⁷⁶ By making this credit refundable, as recommended by the American Council for an Energy-Efficient Economy and Rewiring America, Congress would expand access to these credits for home energy efficiency improvements and help families cool and heat their homes and save money on their electricity bills.⁷⁷ Even if this credit becomes refundable, households that cannot afford to shoulder the up-front cost of energy efficiency upgrades may continue to have difficulty accessing the 25C tax credits. This is why Congress must also invest in point-of-sale rebates for heat pumps and other energy efficiency improvements through the Cool and Healthy Homes Program and the Home Energy Rebates described above.In addition, Congress should raise the $2,000 tax credit limit for heat pumps and heat pump water heaters, which currently only covers roughly 12 percent of the installation costs, to cover 30 percent of the costs to make heat pumps more affordable for households. Congress should also expand 25C to cover upgrades to single-family rental properties made by owners, rather than limiting use of the credit to tenants only.⁷⁸ Lastly, Congress should make new natural gas heating systems and traditional central AC ineligible for 25C credits to avoid subsidizing and incentivizing fossil fuel technologies at the expense of cleaner and more efficient electric heat pumps; it should also update the heat pump standards to ENERGY STAR.⁷⁹
5. Expand and improve LIHEAP and protect households from utilities shutoffs. Congress should pass the Heating and Cooling Relief Act, introduced by Sen. Edward J. Markey (D-MA) and Rep. Jamaal Bowman (D-NY). The bill would expand LIHEAP to ensure that low-income and underserved families secure the financial support they need to pay their energy bills and keep their homes cool in the summer and warm in the winter.⁸⁰ The bill aims to ensure that no household pays more than 3 percent of its annual income on energy costs, the same percentage as higher-income families. As it stands, the federal LIHEAP appropriation helps only 1 of 6 low-income households pay their heating and cooling bills.⁸¹ The bill would also protect consumers from utilities shutoffs and late fees, expand outreach and program participation, and increase funding for energy efficiency and home electrification to help households save money on their electricity bills and reduce fossil fuel pollution.⁸² LIHEAP should also be updated to require utilities to waive reconnection fees and limit shutoffs during periods of extreme weather as a condition for fund utilization.⁸³In addition, Congress should pass legislation clarifying that the Public Utility Regulatory Policies Act (PURPA) bars utilities from power shutoffs during extreme heat and severe cold events to avoid endangering public health.⁸⁴ PURPA already prevents utilities from shutting off power when it would create a health risk, but it does not include explicit protections during heat waves and cold snaps.
6. Provide grants for schools and child care centers to install heat pumps for efficient and cost-effective cooling and heating to ensure that children have a safe and healthy place to learn and play,⁸⁵ with a focus on schools and centers in low-income communities and communities of color.
7. Increase funding for the Urban and Community Forestry Program⁸⁶ in order to expand parks and tree canopies in low-income communities and communities of color, which can reduce extreme heat health risks. Additional federal funds to support cool roofs and cool pavements to cool urban heat islands, such as through the U.S. Environmental Protection Agency’s Environmental and Climate Justice program and the Federal Emergency Management Agency’s (FEMA) Building Resilient Infrastructure and Communities program and Pre-Disaster Mitigation grant program, would also help protect communities from dangerous heat.⁸⁷

By making the above investments, Congress can help families stay safe during dangerous heat, improve the availability of high-efficiency heat pumps for cooling and heating, and help schools and communities lower extreme heat risks.

Although extreme heat is the most deadly type of extreme weather, past presidents have denied requests from governors for disaster declarations and federal disaster assistance related to extreme heat events.⁸⁸ According to the Congressional Research Service, “most Stafford Act declarations provide assistance for sudden-onset hazards that caused structural damage, such as hurricanes.”⁸⁹ This is partially due to the fact that FEMA evaluates the need for disaster assistance based on uninsured disaster damages and costs. However, according to FEMA Administrator Deanne Criswell, a disaster declaration for extreme heat is possible “[i]f the response to an extreme heat incident exceeds the capacity of a state and local jurisdiction.”⁹⁰

To ensure that states can access federal disaster relief to respond to extreme heat events, FEMA should update its definition of “major disasters” to make it clear that extreme heat events are eligible for federal disaster declarations and aid, as recommended by 14 attorneys general; a coalition of labor, health, and environmental advocates; and state energy directors.⁹¹ Doing so would unlock critical resources for local governments to reduce extreme heat risks, for example, through solutions such as cooling centers, community solar, and battery storage to ensure homes, hospitals, and other essential facilities maintain power and stay cool during power outages; expand tree cover and green spaces to cool neighborhoods; and more.

Lastly, the Centers for Medicare and Medicaid Services should develop and widely share guidance for physicians and other health care providers to use diagnostic codes for heat-related illness—and, when applicable, the newly reimbursable diagnostic code for inadequate housing temperature—to more accurately record heat-related injuries and deaths, which are currently severely undercounted.⁹² The Centers for Disease Control and Prevention should also update the U.S. death certificate form to add a request for disaster-related death information, including extreme temperature events, as recommended by the National Association of Medical Examiners.⁹³

The authors would like to thank Shannon Baker-Branstetter, Trevor Higgins, Leo Banks, Jill Rosenthal, Marquisha Johns, Reema Bzeih, Akshay Thyagarajan, Jamie Friedman, Mariam Rashid, Keenan Alexander, Meghan Miller, and Christian Rodriguez of the Center for American Progress for their contributions to this report. The authors would also like to thank Kristin Eberhard of Rewiring America, Mark Kresowik and Lowell Ungar of the American Council for an Energy-Efficient Economy, Mark Wolfe of the National Energy Assistance Directors’ Association, and Steven Woolf of CAP and Virginia Commonwealth University for their input.