Sunday, February 25, 2018
Politics

PolitiFact Florida: Is the GOP health bill bad for seniors? We fact-checked that

A Florida Democrat running for governor is warning about massive insurance rate increases for low-income seniors as part of the House Republican health care bill.

Chris King, a Winter Park businessman, recently called on Gov. Rick Scott and Agriculture Commissioner Adam Putnam to decry the health overhaul based on analysis by the nonpartisan Congressional Budget Office.

"The only thing as reckless and disappointing as the 800 percent premium increases Florida seniors will face under Trumpcare is Rick Scott and Adam Putnam's silence on the issue," King said in a May 25 press release that describes the bill as hiking premiums for low-income seniors. Putnam is running for governor, and Scott is considering running for the U.S. Senate.

Is it true? Does the Republican health care plan, called the American Health Care Act, portend an 800 percent premium increase for low-income seniors?

It depends on your definition of seniors. King's comment could mislead readers to believe seniors on Medicare face 800 percent premium hikes under the terms of the House bill, and that's not the case. The CBO report addresses the impact of the American Health Care Act on individuals up to age 64 who buy on the individual marketplace and not Medicare.

However, he does have a point that low-income, older Americans would be hit harder than any other group under the bill that passed the House and earned President Donald Trump's applause.

CBO researchers considered the effect of the bill on a few different age brackets.

The May 24 report compares the average amount consumers who are 64 years old would spend in premiums under the current Affordable Care Act with what they would pay under the House legislation in 2026.

The bill would create two choose-your-own-adventure scenarios for states, giving them the option to obtain waivers to certain "essential health benefits" under current law. Either scenario, CBO found, means steeper increases for older, poorer Americans.

Here's what the estimates say about average insurance costs for a 64-year-old who earns $26,500 a year in 2026:

• Under the Affordable Care Act, that person would pay a net of $1,700 in premium costs for an individual market plan after subsidies. (A 21-year-old and 40-year-old would pay the same amount.)

• That net premium rises to $16,100 for states not requesting waivers to certain "essential health benefits" under current law. That's a jump of 847 percent.

• For states that obtain those waivers, the premium rises to $13,600, or a 700 percent hike.

Due to those rising costs for low-income, older Americans, the CBO predicted that many will lose insurance.

"Although the agencies expect that the legislation would increase the number of uninsured broadly, the increase would be disproportionately larger among older people with lower income — particularly people between 50 and 64 years old with income of less than 200 percent of the federal poverty level," the report states.

There are two big reasons for this.

Under current law, insurance companies can charge older adults up to three times as much as younger people based on their age. The House bill increases the ratio to five times as much starting in 2018.

Also under current law, tax credits are tied to income, so low-income, older Americans receive large tax credits. Subsidies under the House bill, however, are instead based on age. The credits also don't vary based on the cost of insurance in a person's area.

"The changes to the subsidies and age bands all explicitly increase net premiums for seniors. That piece of the CBO score isn't really up for debate," said Chris Sloan at Avalere Health consulting.

Tax credits for older adults under the bill are only two times the size of that for younger adults, even though they face premiums five times as high, said Linda Blumberg, a health expert at the Urban Institute.

The CBO report shows that wealthier older Americans — 64-year-olds earning $68,500 — would fare far better: They would pay a 5 percent increase in non-waiver states and an 11 percent decrease in waiver states.

"If you're looking for an extreme scenario — someone the most hurt by AHCA — it would be a low-income senior living in a rural area," said Cynthia Cox, an expert at the Kaiser Family Foundation. "The person benefiting the most is a young affluent urbanite."

The CBO figures are based on a national average; insurance premiums could vary from county to county with costs rising in rural areas. A Kaiser map shows that under AHCA, a 60-year-old earning $20,000 a year would face a 772 percent increase for a premium in Miami-Dade. The same senior would pay a 1,594 percent increase in Gadsden County.

The Senate hasn't released its version of the health care bill, which could result in a drastically different situation for older Americans. Trump officials have talked about making other changes that they say would drive down insurance costs.

King's statement is partly accurate but missing needed context. We rate it Half True.

Read more rulings at PolitiFact.com/Florida

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