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5/9/2017 12:51:00 PM
COMMENTARY: Is goal still to make health care affordable?

Kelly Hawes, Tribune-Star CNHI News Indiana Columnist

No one can be certain how the average American will be affected by the health care bill approved this week by the U.S. House of Representatives.

That’s because the measure has not yet been analyzed by the non-partisan Congressional Budget Office, something critics say should have been a necessary first step.

Nevertheless, we know the bill’s key provisions.

According to a report from National Public Radio, the measure would eliminate penalties for failing to buy health insurance. It also would eliminate the requirement that those using federal tax credits buy insurance through the marketplaces created under Obamacare.

Instead, the measure would encourage people to maintain coverage by prohibiting insurance companies from cutting them off or charging more for pre-existing conditions as long as their insurance didn’t lapse. If coverage were interrupted for more than 63 days, insurers would be able to charge a 30-percent penalty for a year.

The bill would eliminate income-based tax credits and replace them with age-based credits ranging from $2,000 a year for people in their 20s to $4,000 a year for those older than 60.

An interactive map put together by the Kaiser Family Foundation shows the impact in 2020 for individuals across the country.

For example, a 27-year-old making $30,000 a year would see costs go up about $2,000 in Nebraska but fall by about the same amount in Washington state.

As a general rule, younger people would save money under the plan, while older people would pay more.

The map shows a 40-year-old making $50,000 a year in Madison County would save $3,000 under the proposed bill, seeing his or her share of annual premiums drop from $4,220 to $1,220. A 60-year-old with the same income, meanwhile, would see premiums go up, from $5,100 under the Affordable Care Act to $8,040 under the American Health Care Act.

You can find the numbers for your county — and lots of other information about the proposed new law — by visiting the foundation’s website at

From what I can tell, the impact seems hardest for those at the bottom of the economic ladder.

According to the foundation’s map, a Madison County resident making $20,000 a year pays a premium of $960, or about 5 percent of annual income under the Affordable Care Act.

Under the American Health Care Act, a 27-year-old earning that amount would pay $1,190, or about 6 percent of annual income. A 60-year-old with the same income would pay $8,040, or more than 40 percent of his or her annual income.

That seems unsustainable.

The bill maintains protections for people with pre-existing conditions, but it allows states to opt out. States could apply for waivers that would allow insurance companies to charge older people more than five times what they charge younger people for the same policy, and they could eliminate the so-called essential health benefits, including maternity care and mental health coverage.

The bill would also allow insurance companies to offer policies with annual and lifetime benefit limits, options that are banned under the Affordable Care Act.

The bill does require states to provide a way for people with pre-existing conditions to obtain coverage, and it allocates up to $138 billion over 10 years to fund such programs. But analysis released this week by Avalere Health concluded that that amount wouldn’t be enough to provide full coverage for those with pre-existing conditions now buying insurance through the individual market.

Say what you will about Obamacare, but the law’s goal was to make medical care available to everyone.

Does that remain the goal of the law’s replacement? If so, the measure seems to be coming up short.

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