As we speak, Republicans in the House of Representatives are busily rewriting the major health care reform bill they plan to vote on tomorrow. The point of all this last-second activity is not to improve the terrible law but to give it a slightly better chance of garnering enough GOP support to actually survive the upcoming vote. If House Speaker Paul Ryan and the Republican leadership were interested in crafting a workable bill that fixes problems in the health care system, they would be taking their time to carefully work out a resolution through the legislative process. Instead, they’re trying to crash land the flaming piece of wreckage that is the American Health Care Act.
And they may yet succeed, which would be awful news for people who need help affording health insurance — specifically, older and low-income Americans. The Congressional Budget Office’s analysis of the AHCA offered a glimpse at how bad the legislation is for old people on the individual insurance market; per the budget office a 64-year-old making $26,500 would see his or her annual premium rise on average from $1,700 to a crushing $14,600. That’s bad, but depending on where a person lives, life under the AHCA could be much, much worse.
The Kaiser Family Foundation put together a neat tool that estimates how individual market insurance premiums would be affected by the AHCA and breaks down the data by age, income and geography. If you’re a young person (say, 27 years old) with a low-paying job ($20,000 annually), you’re very likely going to be worse off under the AHCA than under Obamacare. Outside of Washington state and a few spots in Texas, California, New Mexico and the Rust Belt, the amount of money you would pay after factoring in tax credits would rise. In states like Nebraska, Vermont and North Carolina, premiums would jump by 350 percent to 400 percent.
Younger people who are higher up on the income scale, however, would find their coverage would be far more affordable. A 27-year-old who makes $75,000 annually, for example, would pay less for coverage on the individual market under the AHCA no matter where he or she lives.
As people age, their insurance costs would spiral out of control under the Republican bill. Outside of New York and Connecticut, a 60-year-old who earns $40,000 would likely have to pay several thousand dollars more per year in premiums, according to Kaiser’s estimates. For example, if that 60-year-old lives in Arizona's Yuma County, his or her annual premium costs would jump 548 percent — from $4,080 to $26,450. That would amount to 66 percent of that person's annual income going toward health insurance, after factoring in tax credits.
The situation would worsen the lower you are on the income scale. If you’re 60 years old and pulling down $20,000 a year, you would be, to put it bluntly, screwed. Regardless of where you live, your insurance costs on the individual market would spike by large or, in some places, ludicrous amounts. In Pennsylvania's Lancaster County, a low-income 60-year-old currently pays $960 in annual premiums. Under the AHCA, he or she would fork out $17,460 — a 1,723-percent increase.
In Nebraska's Lincoln County, a 60-year-old would be staring at a 2,207 percent jump. The annual premium (after the AHCA's tax credit is factored in) would rise to $22,100, or 111 percent of the person's annual income. In Arizona's Yuma County, such a person would face a 2,661 percent premium surge and would need to spend 132 percent of his or her annual income on health insurance.
Those numbers are, of course, absurd. And they help explain why the Congressional Budget Office forecasted that some 24 million more people would become uninsured under the AHCA. The bill is seemingly designed to price old people out of the individual insurance market; it slashes the amount they can receive in premium tax credits while enabling insurance companies to charge them more in premiums. The situation seems only marginally less horrible for younger people at the bottom of the income scale, who will merely face premium increases of 300 percent or 400 percent instead of a preposterous 2,000 percent.
Data like this show that the American Health Care Act is completely backward in how it approaches the health care system. The people who need the most amount of help in purchasing health insurance coverage are thrown to the wolves while those who earn more money will have an easier time obtaining coverage. It’s bad policy that’s being slapped together on the fly just so Republicans can say they kept a campaign promise.