Can GOP craft an affordable alternative to the Affordable Care Act?

Jan. 14--No part of the Affordable Care Act is more misunderstood, experts say, than the costs paid by users.

President-elect Donald Trump and Republican lawmakers leading the charge to repeal the law frequently cite skyrocketing health insurance premiums for their disdain for the law.

In addition, the high deductibles that many plans carry render the insurance virtually unusable, they say, even if policyholders can afford the premiums.

But the truth is most health plans are required to cover recommended preventive care, such as cancer screenings for certain age groups, without charging consumers anything out of pocket even if their deductible hasn't been met.

And only a fraction of the people who have signed up for private health plans under the law, commonly referred to as Obamacare, have had to absorb the full brunt of premium rate hikes, which were projected to spike about 13 percent in Ohio for 2017.

That's because the vast majority of those enrolled in commercial health plans under Obamacare receive monthly income-based subsidies from the government to keep the cost of their premiums under 10 percent of their annual income, as required by the law.

In fact, more than eight out of 10 people who enroll through HealthCare.gov -- the website for enrollment in Obamacare health plans in Ohio and 39 other states that comprise the federal Health Insurance Marketplace -- qualify for financial help, lowering most people's premiums to $50 to $100 a month, according to the latest figures from the U.S. Department of Health and Human Services.

The U.S. House Friday took the first step toward repealing the health care law, though nine Republicans joined Democrats in opposing the measure. Republicans now will set about crafting an alternative that is more affordable than the Affordable Care Act.

That would be welcome news to those who complain about prices. The average annual premium for marketplace enrollees who don't qualify for premium tax credits in Ohio -- about 48,000 members last year -- is $5,065 in 2017, according to figures from the Ohio Insurance Department. That's a whopping 90 percent increase from 2013 when the Health Insurance Marketplace launched.

"On one hand, it's misleading to say health insurance premiums have gone up for everyone under the Affordable Care Act," said John Bowblis, a Miami University economics professor who specializes in health care. "On the other hand, those price increases are real and unaffordable for many people who don't get the subsidies."

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