Health Team

GOP's health plan could cost older, rural NC residents thousands each year

Posted March 15

— The American Health Care Act, the Republican's plan to replace former President Barack Obama's Affordable Care Act, could cost older Americans thousands of dollars more each year, according to health care experts.

Dr. Jonathan Oberlander, a professor of social medicine at the University of North Carolina at Chapel Hill School of Medicine, said different age groups and income brackets will be affected differently.

The demographic that will be hit hardest by this new plan, Oberlander said, are low-income people between ages 55 and 64 who live in rural areas.

In Wayne County, the GOP's replacement could cost people $11,000 more per year:

–Tax Credit (subsidy) Under Obamacare in 2020: $15,210

–Tax Credit Under GOP Plan in 2020: $4,000

Oberlander said the reason rural areas are hit harder is because the tax credit under Obamacare is based on the cost of insurance in that area—the cost of insurance is typically higher in rural areas.

Under the Republicans plan, though, the tax credit is based on one national rate, so it doesn't matter how much insurance costs where you live.

The Republican bill also allows insurers to charge older enrollees five times as much as younger enrollees, which could also make it more expensive for older age brackets.

"Under this Republican plan, insurers can now charge older Americans five times the amount they charge younger Americans," Oberlander said. "That's much higher than what is allowed under the ACA. The bottom line it the premiums are going to be much higher that are charged, and the subsidy is going to be lower."

Oberlander said thousands of North Carolinians in that age bracket won't be able to afford insurance

But in Wake and Durham Counties, older Americans will still get a much lower tax subsidy under the new GOP plan.

For people who are at least 60 years old and make $40,000 per year in Wake County:

–Tax Credit (subsidy) Under Obamacare in 2020: $10,610

–Tax Credit Under GOP Plan in 2020: $4,000

It's about the same in Durham County:

–Tax Credit (subsidy) Under Obamacare in 2020: $11,090

–Tax Credit Under GOP Plan in 2020: $4,000

The plan would leave buyers with less money to purchase insurance in the Healthcare Marketplace.

Older Americans typically need more care, more often. They would have to hope for manageable premiums to be able to afford insurance. Oberlander said that could be a hit to the healthcare system in our state."

"They'll go uninsured," Oberlander said. "They'll go back to emergency rooms and hospitals like this. They'll go to safety net clinics, and a lot of them will do without (treatment)."


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  • Thomas White Mar 15, 6:08 p.m.
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    The Affordable Care Act may not be perfect, but it is better then the Republican plan where a gynecological exam is a "p*ssy grab" for the women and a male exam is just a "kick in the nuts".

  • Teddy Fowler Mar 15, 4:24 p.m.
    user avatar

    Could cost? Nobody even knows what the final product will be at this point as it will surely change as it moves through the house and senate. And I remember all those great things said about Obamacare that never even remotely came true.

  • Chris Perdue Mar 15, 3:45 p.m.
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    Look at it this way though. If you find out you have cancer, should you be able to sign up for the same price as your healthy neighbor during open enrollment. Should the insurance company be mandated to accept your $500/month premium knowing you will cost them $tens of thousands/month? I know this sounds heartless, but finding out you are sick should not be a qualifying event to go out and purchase insurance, which is what the system allows now as long as it is in open enrollment. It is like being able to purchase homeowner's insurance when you smell smoke from the faulty wiring. There is nothing in place that penalizes anyone enough for not signing up for insurance when they are healthy. The fine is nothing, and if you don't file a tax return or are not due a refund, then there is no penalty applied anyway.

  • William Sherman Mar 15, 3:35 p.m.
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    perfect analogy,

  • William James Mar 15, 2:34 p.m.
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    Allowing Washington politicians to craft a new health care system is like giving Chimps a ton of gunpowder and a pack of matches, then expecting them to build a NASA rocket.

  • William Sherman Mar 15, 1:32 p.m.
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    Trump a liar? Really? Are you comparing him to say--Clinton--the most documented confirmed liar in American political history--coming in right behind the Golden Savior of the Demo party Obama? Whatever you are smoking, I would greatly urge you to put it down--its effecting you grasp on reality.

  • Rod Runner Mar 15, 1:31 p.m.
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    But you can also buy service plans for cars that cover oil changes and repairs, and they are basically like insurance. It's because not everyone that buys it uses it, so the company selling these things still make money. You know how else they make money? By refusing to do repairs that you think are covered under the service plan.

    This is exactly what insurance companies do to people. I've had insurance deny claims that I know are right and I had to call them to make them pay. They do this randomly, to make profit. They know some people won't call and those people then have to pay the hospital. (or not pay and just have the hospital write off the debt, which costs us all more money.)

  • Rod Runner Mar 15, 1:26 p.m.
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    So you believe that insurance companies don't already do what you think the government would do?

    Unless you can pay out of pocket for tests and procedures, insurance companies will only cover needed ones and only in a timeline that they specify.

    My mom just recently had to have a CT scan in the ER, she got that. But insurance mandated that it be 5 days until another one could be done. By then, the issue she had to have the CT scan for had gotten worse, and would have been better if they could have scanned the day before and found it quicker.

    Insurance companies are all about profit as well. You think they do better than the government would? Pray tell me how.

  • Rod Runner Mar 15, 1:21 p.m.
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    Also, everyone, never forget this:

    The new GOP healthcare bill includes allowing healthcare companies to deduct the full compensation of their top executives from their taxes.

    You really want to give this tax break, which is your money, to these companies for simply paying their executive salaries? The people who set these salaries are the people in charge of filing the taxes.

    Is this how you envision your health insurance working?

    If this something you believe should be in legislation?

    Do you feel that the insurance companies need to deduct the pay of their executives?

  • Chris Perdue Mar 15, 1:06 p.m.
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    My point is exactly what you said. People are not paying in now that need to be b/c it is to expensive. Young people need a high deductible option that is affordable. Treat it like auto insurance. Use insurance if something is major, but pay out of pocket for oil changes, tires, etc. Same with Rx and urgent care. The system now allows you to sign up for insurance when you need it. So you can wait until you are older and sicker before applying during open enrollment with no consequence. System works best when young people sign up and pay for years before they need it. In 2013 my BCBS Blue Advantage $5,000 H S A was $93/month for a 45 year old. it is now $575 for a $5,500 H S A for a 45 year old. But it has all the bells and whistles added--and no discount like in the past for being healthy.