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GOP health plan means bigger financial hit for older low-income enrollees in South Sound

Dr. Lucinda Grande (right) talks with patient Rick Gleason at the Pioneer Family Practice clinic in Lacey on April 21, 2015. Gleason said that tiny doses of ketamine have successfully relieved his previously untreatable pain.
Dr. Lucinda Grande (right) talks with patient Rick Gleason at the Pioneer Family Practice clinic in Lacey on April 21, 2015. Gleason said that tiny doses of ketamine have successfully relieved his previously untreatable pain. Staff file, 2015

Under the proposed Republican plan to replace the Affordable Care Act, older enrollees in the lowest income bracket in the South Sound and Washington state will pay more money out of pocket for coverage, according to a nationwide analysis by the Associated Press.

The Associated Press has compared the difference in benefits between the proposed American Health Care Act and the subsidies provided by the Affordable Care Act, commonly called ACA or Obamacare.

The analysis counted enrollees ages 55-64, as well as 65 and older, as “older enrollees.” Washington has 225,594 total ACA enrollees in 2017, with 69,206 older enrollees — about 30.7 percent.

Those in the 55-64 age group are most affected by the proposal because they are not yet eligible for Medicare but might lack employer-sponsored health care, according to the AP.

The average ACA tax credit for a 60-year-old enrollee in the state with an income of $20,000 a year is about $6,340. The Republican proposal calls for replacing the subsidy with a $4,000 flat tax credit by 2020, which means $2,340 less for people in this income bracket to offset their premium costs.

Washington residents are in better shape to handle the change than other states. A 60-year-old in the lowest income brackets could see a loss of $10,000 or more under the new proposal in states like Alaska, North Carolina, Oklahoma, Arizona, Wyoming and Nebraska.

In Thurston and Pierce counties, a 60-year-old enrollee in that same income bracket ($20,000 a year) would see about $2,280 less, while a 60-year-old enrollee who makes $30,000 a year would see about $760 less under the new proposal, according to the AP data.

People in the higher-income brackets in Thurston and Pierce counties would receive more in health care subsidies under the Republican plan.

According to the AP analysis, an older enrollee who makes $40,000 a year would receive about $840 more, while an older enrollee making $50,000 a year would see $1,860 more under the new proposal.

An older enrollee who makes $75,000 a year would receive $4,000 more, and an older enrollee making $100,000 a year would see $1,500 more, according to the AP.

The Republican health care plan is still evolving, and the House is expected to vote on it Thursday. Republican House Speaker Paul Ryan of Wisconsin submitted two amendment packages Monday night to gain support from more conservative party members. The amendments include halting the ability for states to expand Medicaid and allowing states to enact work requirements for recipients, according to reports.

“A lot of people just won’t be able to afford to pay it,” a spokesperson from the nonprofit Kaiser Family Foundation told the AP. “A lot of people are going to drop out of the market altogether.”

The analysis also shows which presidential candidate — Donald Trump or Hillary Clinton — each U.S. county chose in the November 2016 election. Under the Republican proposal, the analysis shows that in the 443 hardest-hit counties — where 60-year-old enrollees in the lowest tax bracket stand to lose $10,000 or more in tax credits — 41 of those counties voted for Clinton, while 402 counties voted for Trump.

The AP reports that counties with the strongest support for Trump will see costs for older enrollees rise an average of 50 percent more than counties with the least amount of support for Trump.

The nonprofit Kaiser Family Foundation focuses on national health issues and served as one source for the AP analysis. The foundation has posted an interactive map with the entire raw data set online at kff.org.

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