Republicans' Obamacare replacement bill: The winners in addition to also losers

Rand Paul blasts GOP for keeping health plan 'secret'

Republican lawmakers have long vowed in which they can make health care more affordable in addition to also accessible. Americans will today see if Congress can keep in which promise.

The House finally revealed its plan to repeal in addition to also replace major portions of the Affordable Care Act on Monday. While the bill will likely change a lot before in which lands on President Trump’s desk, in which’s already possible to see whom the winners in addition to also losers from the individual market in addition to also Medicaid could be.

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Related: Republicans unveil bill to repeal in addition to also replace Obamacare

Titled the American Health Care Act, the legislation calls for providing refundable tax credits based on a person’s age in addition to also income. in which keeps the Obamacare protections for those with pre-existing conditions, yet in which allows insurers to levy a 30% surcharge for a year on the premiums of those who let their coverage lapse. in which lifts the taxes in which Obamacare had imposed on the wealthy, insurers in addition to also prescription drug manufacturers. in addition to also in which loosens or removes several of the health reform law’s strict insurance reforms to ensure carriers can offer a wider — in addition to also some say skimpier — suite of policies.

The bill also eliminates the enhanced federal match for Medicaid expansion starting in 2020 in addition to also revamps the funding for the entire Medicaid program.

The most glaring weakness of the GOP bill will be in which in which will likely leave millions uninsured, experts said. Republican lawmakers have repeatedly skirted in which question, yet reviews of preliminary drafts by the Congressional Budget Office confirmed the problem, sources said.

“With Medicaid reductions in addition to also smaller tax credits, in which bill would likely clearly result in fewer people insured than under the ACA,” said Larry Levitt, senior vice president at the Kaiser Family Foundation. “The House GOP proposal seeks to reduce what the federal government spends on health care, in addition to also in which inevitably means more people uninsured.”

Experts remain divided over the impact on the individual market. Some say insurers would likely flee or jack up their rates if millions of people drop out. Others contend in which the Republican bill would likely stabilize the market in addition to also premiums because the reforms would likely give insurers more flexibility in addition to also entice more younger enrollees to sign up for coverage.

“If we let the ACA continue on its current trajectory, people actually will lose coverage,” said Doug Badger, senior fellow at the Galen Institute, a free-market, health-care think tank.

Here’s who would likely likely lose under the Republican plan:

Lower-income folks could be left uninsured. Obamacare contains many provisions to help poor in addition to also lower-income Americans. in which expanded Medicaid to cover adults who earn up to $16,400 a year — some 11 million people in 31 states in addition to also the District of Columbia are today insured as a result.

Also, those with incomes just under $30,000 receive generous subsidies to lower their premiums, deductibles in addition to also out-of-pocket costs on the individual market.

The American Health Care Act would likely reverse much of in which. in which would likely end the enhanced federal Medicaid funding for fresh enrollees starting in 2020. Those already from the program could stay as long as they remain continuously insured. yet since up to half have a break in coverage each year, in which’s likely participation would likely fall off quickly, said Jocelyn Guyer, managing director at Manatt Health, a consulting firm.

yet the Republican bill would likely go beyond just eliminating Medicaid expansion. in which would likely overhaul the whole program, which covers more than 70 million people, by sending states a fixed amount of money per enrollee, known as a per-capita cap. in which would likely limit federal responsibility, shifting in which burden to the states. However, since states don’t develop the money to make up the difference, they would likely likely either reduce eligibility, curtail benefits or cut provider payments.

Related: Higher-income Americans win under Republican plan to repeal Obamacare

All in which could hurt not only poor adults, yet also low-income children, women, senior citizens in addition to also the disabled.

The legislation also would likely eliminate the subsidies in which reduce deductibles in addition to also co-pays for moderate-income policyholders on the individual market. in addition to also the tax credits in which would likely provide would likely not go as far Obamacare’s subsidies.

Folks creating $20,000 a year take the biggest hit at any age under the GOP plan, a recent Kaiser study found. A 27-year-old would likely get only $2,000, instead of $3,225 under Obamacare, on average, while a 40-year-old would likely get $3,000 versus nearly $4,150.

However, the biggest loser would likely be a 60-year-old, who would likely receive only $4,000, instead of nearly $9,900 under Obamacare.

Older Americans could have to pay more. Enrollees in their 50s in addition to also early 60s benefited through Obamacare because insurers could only charge them three times more than younger policy holders. The bill would likely widen in which band to all 5-to-one.

in which would likely mean in which adults ages 60 to 64 would likely see their annual premiums soar 22%, or nearly $3,0, to nearly $18,000, according to a study by the Milliman actuarial firm on behalf of the AARP Public Policy Institute. Those in their 50s would likely be hit that has a 13% increase, or just over $1,500, in addition to also pay an annual premium of $12,800.

Also, the GOP bill doesn’t provide them as generous tax credits as Obamacare. A 60-year-old creating $40,000 would likely get only $4,000 through the Republican plan, instead of an average subsidy of $6,750 through the Affordable Care Act, according the Kaiser study.

The sick could get coverage, yet in which could be more limited. The GOP plan actually provides stronger protections for those with pre-existing conditions than some prior Republican proposals. Like Obamacare, in which requires insurers cover these folks in addition to also prevents carriers through charging them more because of their health.

yet the Republican plan would likely lift the requirements in which insurers cover a certain share of the costs in addition to also provide a specific array of benefits — such as maternity in addition to also prescription drug coverage. in which change would likely allow carriers to offer a wider selection of policies, including more with limited benefits. in which could make in which more costly — or more difficult — to find more robust plans in which the sick often need.

“You won’t be able to find a comprehensive plan anymore,” said Sabrina Corlette, research professor at Georgetown University’s Health Policy Institute.

Here’s who would likely likely win:

Younger Americans could get cheaper plans. Obamacare was designed to ensure younger policyholders would likely help subsidize older ones. in which would likely change under the Republican bill because in which would likely allow insurers to charge older folks more.

in which means in which younger Americans would likely likely see their annual premiums go down. Enrollees age 20 to 29 would likely save about $700 a year to $4,000, on average, according to the Milliman study for the AARP.

Related: Full text: GOP plan to repeal in addition to also replace Obamacare

Those under age 30 would likely also get a refundable tax credit of up to $2,000 to offset the cost of their premiums, as long as their income doesn’t exceed $215,000 for an individual. in which’s more likely in which younger folks who are earlier in their careers would likely fall under in which cap.

The GOP tax credits would likely also likely be more generous than Obamacare’s subsidies for these folks. For example, a 27-year-old creating $40,000 a year would likely receive $2,000 under the GOP plan, yet only gets a $103 subsidy through Obamacare, on average, a Kaiser analysis found.

The healthy could buy less expensive policies. Some Americans are not happy in which Obamacare has forced them to buy more comprehensive policies with higher premiums in which provided what they consider to be needless benefits. The American Health Care Act would likely Once more let insurers sell skimpy plans.

yet these bare-bones offerings — which come with lower premiums — are all some healthier Americans want. Restoring these options would likely draw in some folks who’ve opted to remain uninsured in addition to also pay a penalty, rather than sign up for too-generous policies, Republican lawmakers argue.

Higher-income Americans could pay fewer taxes, get more tax benefits. The legislation would likely eliminate two taxes in which Obamacare levied on the wealthy to help pay for the law. Nearly everyone from the Top 1%, who earn more than $774,000 a year, would likely enjoy a hefty tax cut, averaging $33,000, according to the non-partisan Tax Policy Center. Those from the Top 0.1% would likely get an average tax cut of about $197,000.

in addition to also the bill would likely allow folks to contribute more to Health Savings Accounts, which are primarily used by better-off Americans who can afford to sock money away for health care expenses.

Also, the Republicans would likely enable people higher on the income scale to claim the tax credit to help pay their premiums. Under Obamacare, an enrollee who makes more than $47,500 will be no longer eligible for a subsidy. The GOP plan would likely let a policyholder creating up to $75,000 claim the full tax credit. The benefit would likely phase out slowly until the enrollee hits $215,000 in income.

Insurance companies could get a big tax break. Obamacare allowed insurance companies to deduct only $500,000 of their executives’ pay as a business expense. The GOP bill would likely repeal in which limitation, starting in 2018.

Top insurers pay their leaders millions in compensation every year so in which provision could mean a nice tax savings for the companies.

sy88pgw (fresh York) First published March 6, 2017: 10:52 PM ET


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Republicans' Obamacare replacement bill: The winners in addition to also losers

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