The U.S. House of Representatives today postponed a vote on a health care overhaulΒ bill that would impact millions of Americans.
On Wednesday the Center on Budget and Policy Priorities released a report that said Arizonans, particularly older residents, would pay more under the house bill. If passed, the bill as it stands would take full effect in 2020.
The center says the House Republican Affordable Care Act (ACA) repeal bill will increase total out-of-pocket health costs — premiums, deductibles, co-pays, and coinsurance — by an average of $3,600 for HealthCare.gov marketplace consumers across the country.
But in Arizona, costs will increase by more, an average of $4,927.
Some additional information about Arizona in the report:
β’Β The House billβs tax credits β unlike the tax credits under the Affordable Care Act β do not adjust with the size of premiums. That means the actual amount that people pay will rise by much more, as tax credits will fall by an average of $3,660 per year.
In total, that means that the average Arizonan with marketplace coverage will pay $4,006 more to cover the cost of their premiums under the House bill.
β’ The bill would increase out-of-pocket costs for Arizonans by an average of $921 per year.Β
The House bill also makes it more likely that insurers offer only higher-deductible plans, while repealing cost-sharing subsidies that keep out-of-pocket costs lower for many low- and moderate-income Americans.
β’ Older Arizonans will face even greater challenges.Β The House bill both lets insurers charge older people much higher (pre-tax credit) premiums than under current law and cuts their tax credits the most compared to the ACA.
A "reserve fund" would fail to solve these problems and still leave Arizonans paying thousands more.
House Republicans have offered an amendment to their original bill that theyβve described as making up to $85 billion available for higher tax credits for older Americans.
But even if that entire sum is used for that purpose, it will still leave Arizonans paying thousands of dollars more than under the ACA.
Assuming generously that an amended bill includes $85 billion in additional tax credits, cost increases would still be 87 percent as large in Arizona as under the original bill.
With that reserve in place, a 60-year-old making $22,000 a year would still end up paying premiums of $12,774, which is more than 10 times what they would pay under current law.
MEDICAID IMPACT
A memo from Pima County Administrator Chuck Huckelberry dated March 22 says that if the American Health Care Act is enacted as drafted, it would end Medicaid for 380,000 Arizonans, including 57,000 people in Pima County.
If the state wanted to continue paying for childless adults in Arizona to be covered by Medicaid, that would increase state costs by $478 million, according to a state analysis completed March 15.
In Arizona Medicaid is called the Arizona Health Care Cost Containment System (AHCCCS). It is a government insurance program for low income people.
Citing the state analysis, Huckelberry's memo says the pending legislation would cut $2.5 billion per year in federal funds received in the Arizona economy.
"Unfortunately, this appears to be a major step backward in providing reasonable healthcare and medical services," he wrote.
The state analysis was completed before additional changes, including a reserve fund, were added to the legislation earlier this week.
INDIVIDUAL MANDATES
Tucson insurance broker Ray Magnuson, who owns Magnuson & Associates, says his biggest concern with efforts to overhaul health care is losing the individual mandate, which requires Americans to purchase health insurance.
Losing that mandate seems inevitable, since it is one of the items most often cited when critics talk about repealing the ACA.
If no one is mandated to have insurance, then younger, healthier people are less likely to buy it. That not only creates instability, it makes insurance companies less likely to offer affordable individual plans, he said.
"If insurance is only covering some people, it can't work. That's not what insurance is about," Magnuson said. "That is like saying it's good to enroll in auto insurance but you don't have to enroll in it until after you have an accident."
An analysis released Thursday by the Congressional Budget Office and the Joint Committee on Taxation estimates thatΒ in 2018, 14 million more people would be uninsured under the legislation than under current law.
In 2026, an estimated 52 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law, the analysis says.
