Experts worry about impact of proposed Obamacare replacement
"The affordability for people who are older will not be the same as under the Affordable Care Act, so older people will be dropping coverage," said
The
In 2026, 52 million people would be uninsured under the
According to
The CBO reports that by 2026, about 30 percent of people age 50 to 64, living on
There are a number of reasons for the anticipated drop in coverage, Guss said. One key difference is how subsidies are distributed to health care purchasers on the individual market. Under Obamacare, tax credits were distributed based on a person's income and the cost of health care plans where that individual lives.
Under the proposed Republican plan, tax credits are fixed -- regardless of income -- and based on age. Buyers younger than 30 would get a
At the same time, the
The bill's proposed changes to the age band rating, combined with changes to the tax credit system, would lead to significant changes in the cost of premiums for older, low-income adults, according to the CBO report.
Under current law, a 64-year-old making
Under the
"You can just look at what that person would be paying and say, 'OK, there's no way they can afford that,'" Guss said. "Older folks will stop getting coverage through this new mechanism and really, there wouldn't be anything else for them. Because unless you're even lower-income, you're not going to qualify for
Even higher earners might drop health care coverage based on affordability, Guss added. According to the CBO report, a 64-year-old making
Consumers would pay greater out-of-pocket costs because the proposed bill eliminates cost-sharing subsidies -- government reimbursements for health care deductibles.
Because the
"You're not going to buy insurance until there's something imminent, and even then, you might not be able to afford it," Guss said. "It's a no-win situation for these older folks. And these are the people who are going to go and get emergency care, and then insurance companies will just have to swallow the costs."
Changes in
A bigger concern to many advocates is the bill's suggested changes to
Under the
To
What many don't understand, Powell said, is that many seniors depend on both
It also helps pay for PACE -- the Program of All-Inclusive Care for the Elderly -- which provides preventive and primary care for people 55 and older, to keep them out of long-term care and in the community.
"People see the word '
In 2016, 2,110 residents in
By 2030, an estimated 6,248
The cuts to
By 2030, Montgomery said, the number of people 65 and older in the
With that increase will come more seniors depending on both
"
Dr.
Before Obamacare and before
"We're going to see patients who can currently go to the doctor or hospital, but will start to come to the ER as charity patients," Berman said. "And those are costs that the hospital will not be able to recoup."
Relying on hospitals for primary care isn't the best approach for patients.
"As a former ER doctor, I can tell you that's a terrible way to get care," Berman said. "It's not focused on healing. You're coming in only when the worst happens, and you're never seeing the same doctors."
"Cutting costs by cutting service to the poor and elderly is tragic," he added. "I guess some politicians will say that if those people didn't save money, it's their fault. Well, I find that absolutely reprehensible."
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