AARP opposes Obamacare repeal plan over tax credit, Medicaid changes

March 09--The House Republican bill that would replace Obamacare has an opponent with 1.8 million members in Pennsylvania -- the AARP.

The advocacy group, which represents 38 million seniors nationally, announced this week that it does not support the American Health Care Act, saying the legislation from congressional Republicans would weaken Medicare's funding, hurt seniors enrolled in Medicaid, and hike premium costs for those ages 50 to 64.

In a rapidly aging state like Pennsylvania, where one in six residents is 65 or older, many are watching to see what the proposed health care changes will mean for them.

"We're hearing from members who are worried," said Ray Landis, advocacy manager for the state's AARP chapter. "They see this and hear this and think it might be happening to them tomorrow."

Asked during his briefing Wednesday about AARP's opposition, White House press secretary Sean Spicer brushed off the concerns, saying the group "got a really good deal last time when it came to prescription drugs, in particular."

"This isn't about trying to figure out how many special interests in Washington we can get paid off. It's about making sure that patients get the best deal that lowers prices," Spicer said.

Landis said they've responded to concerned members by explaining the legislative process, and that the Republican bill introduced this week is still getting its first round of scrutiny.

That early review from AARP staffers and other health policy analysts flagged several potential areas of concern for older Pennsylvanians who are not yet eligible for Medicare, as well as those enrolled in Medicaid.

For those 50 to 64 who are not yet eligible for Medicare -- a group that nationally saw its uninsured rate drop by nearly half between December 2013 and March 2015 -- the bill is expected to result in higher premium costs. That's due to two changes:

--A shift in how tax credits are structured compared to the current Obamacare subsidies.

--A provision allowing insurers to increase the price they charge older individuals.

Under the Affordable Care Act, or Obamacare, credits to offset premium costs were calculated based on the cost of insurance in an area and a purchaser's income. The Republican approach bases those $2,000 to $4,000 credits solely on age, with younger individuals eligible for less and older individuals receiving more.

An analysis from the Kaiser Family Foundation found that older, low-income individuals would receive much less under the GOP proposal than they currently receive under Obamacare.

In Lehigh and Northampton counties, a 60-year-old earning $20,000 a year currently could receive a credit of $4,000, compared to $14,270 under Obamacare.

By comparison, a 40-year-old making the same amount would be eligible for $3,000, compared to $6,210 currently.

The proposal also would undo an ACA provision that limited how much insurers can charge older consumers compared to younger ones.

Under Obamacare, the oldest individuals pay no more than three times the premium amounts charged to younger consumers. That would increase under the GOP plan, allowing for costs that are five times what younger individuals pay.

AARP estimated that those policies would lead to premiums increasing by as much as $3,600 for a 55-year-old earning $25,000 a year, $7,000 for a 64-year-old earning $25,000 a year, and $8,400 for a 64-year-old earning $15,000 a year.

"Significant premium increases for older consumers will make insurance less affordable, will not address their expressed concern of rising premiums, and will only encourage a small increase in enrollment numbers for younger persons," AARP Senior Vice President Joyce Rogers wrote in a letter to Congress.

The advocacy group also flagged concerns with how the bill would change Medicaid, which serves low-income or disabled individuals. Nationally, there are 7 million Medicaid enrollees over 65, and 10.8 million that are enrolled in both Medicare and Medicaid due to their income or a disability.

In Pennsylvania, roughly 10 percent of Medicaid enrollees are low-income seniors, who rely on the program to pay for nursing-home or other long-term care options.

The GOP proposal would limit Medicaid funding, capping the amount of federal dollars sent to states for each enrollee. Advocates say that would pose a challenge in a state where the number of older residents is growing much more rapidly than the overall population, and will be needing increasingly costly care.

"The question becomes: With more and more people potentially needing long-term services as the population grows older, can we afford to cover all of these people for long-term care and nursing home services?" Landis asked. "Do we have to make choices between covering those costs and covering the costs for younger people?"

lolson@mcall.com

202-780-9540

ACA VS. GOP PLAN

Analysts at the Kaiser Family Foundation estimated how the Republican health care bill would affect how much someone can receive in tax credits to subsidize their insurance costs. In Lehigh and Northampton counties, here's how the eligibility for a 60-year-old would change based on income:

--$20,000: $14,270 in tax credits under Affordable Care Act; $4,000 under GOP plan

--$30,000: $12,750 under ACA; $4,000 under GOP plan

--$40,000: $11,150 under ACA; $4,000 under GOP plan

--$50,000: $10,130 under ACA; $4,000 under GOP plan

--$75,000: $0 under ACA; $4,000 under GOP plan

--$100,000: $0 under ACA; $1,500 under GOP plan

Source: Kaiser Family Foundation

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