Health care costs for Bay Area residents who buy their insurance on the individual market would be more expensive under the Senate’s plan to replace the Affordable Care Act compared to the GOP House plan, according to new county-level projections of premiums and tax credits by the Menlo Park-based Kaiser Family Foundation.
As the GOP majority Senate prepares to vote this week to dismantle Obamacare, estimates of how much a person buying their own insurance would have to pay in 2020 under the Senate replacement bill compared to Obamacare show that in some counties, Bay Area residents would lose up to four times as much in tax credits under the Senate plan versus the Republican-led House plan, which passed on May 4.
The two plans use different methodologies to calculate credit amounts: Like Obamacare, the Senate plan’s tax credits take family income, local cost of insurance, and age into account, while the House bill bases tax credits only on age, with a phase out for individuals with incomes above $75,000.
Some of the comparisons are staggering: Based on the foundation’s numbers, a 40-year-old Santa Clara County resident who earns $30,000 a year and pays a $5,790 annual premium under a benchmark Silver plan would receive $1,240 less in tax credits under the GOP Senate’s proposed Better Care Reconciliation Act compared to the Affordable Care Act. Under the House plan, called the American Health Care Act, that person would lose $310 in tax credits annually.
Similarly, that same 40-year-old in Alameda County who pays a $5,860 annual premium would receive $1,020 less in tax credits under the GOP Senate plan compared to Obamacare; he or she would lose $380 in tax credits under the House plan.
Meanwhile, in Contra Costa County, a person paying a $6,370 annual premium would receive $1,630 less under the GOP Senate plan compared to Obamacare, while that person would lose $890 in tax credits under the House plan.
But the foundation noted an important change since the May 4 House vote: The House’s plan would allow states to waive certain consumer protections, including essential health benefits, age rating and community rating. The latter is a rule that prevents health insurers from varying premiums within a geographic area based on age, gender, health status or other factors.
If a state takes up such a waiver, the premium amounts for that state would no longer be applicable. Enrollee costs, for example, could depend on their health status, with healthy people paying less and sicker people — or those with pre-existing conditions — paying more, the foundation said.
Kaiser said its method of estimating premiums before tax credits under the Senate plan is based on Congressional Budget Office projections for the House plan, which suggest that the premium for a 40-year-old under the House plan would be similar to the premium for a 40-year-old under the Affordable Care Act, before accounting for tax credits and for the same level of coverage.
On Monday afternoon, the CBO released its analysis of the Senate plan. It shows that 22 million more Americans would be uninsured in 2016 as a result, and would reduce the federal deficit by $321 billion over 10 years.
Last month, the CBO’s score of the House bill predicted it would reduce the deficit by $119 billion over 10 years, but also leave 23 million more people uninsured in 2026 than if Obamacare was kept in place.