How the Senate Health Bill Would Affect Health Insurance Coverage in Arkansas
The
Yet even these numbers understate the bill's impact on
Impact on Marketplace Consumers
About 60,000 Arkansans obtain coverage through the Affordable Care Act (ACA) marketplace.[2] The bill's effects on these consumers would vary by age and income, but overall, most people would be significantly worse off, and tens of thousands would likely become uninsured. Specifically, the
1. Older marketplace consumers with incomes between 350 and 400 percent of the poverty line (about
Marketplace consumers with incomes between
2. Most marketplace consumers with incomes between 200 and 350 percent of the poverty line (about
The latter change would leave consumers with a choice: purchase coverage with far higher deductibles, or pay more to maintain the coverage they have now. The median bronze plan had a deductible of
On top of that, older people in this income range would see higher premiums even if they switched to higher-deductible plans, because of the
3. Consumers with incomes between 100 and 200 percent of the poverty line (about
Deductibles at these levels would almost certainly prevent lower-income people from obtaining needed care. And, faced with deductibles that would prevent them from actually using their health insurance, many low-income people would likely drop coverage altogether.
4. Older people at higher income levels. For higher-income Arkansans purchasing unsubsidized coverage through the marketplace (or in the off-marketplace individual market), the major change in the
Taking into account all of the changes discussed above, the
In addition, all Arkansans purchasing individual market coverage could be affected by the
Weakening essential health benefits standards would especially harm people with pre-existing conditions. As the
Impact on People Currently Covered by Medicaid
The
Under the
While people losing coverage under expansion could obtain marketplace subsidies under the
* First, premiums alone would put coverage out of reach for many people with incomes below the poverty line. Under the
* More importantly, because the
* In addition, as noted above, the
Meanwhile, the
Cuts of this magnitude would necessarily jeopardize coverage and reduce the quality of coverage for
Impact on Arkansans with Employer Coverage
The
That's because the ACA's prohibition on annual and lifetime limits only applies to coverage of services classified as essential health benefits. So if states eliminated or greatly weakened essential health benefits standards, plans could go back to imposing coverage limits on any services excluded from essential health benefits -- including for people covered through their employer. Moreover, because large employer plans are currently allowed to select any state's definition of essential health benefits to abide by, essential health benefits waivers in any state could mean a return to annual and lifetime limits for people in employer plans nationwide.[13] Before the ACA, 865,000 Arkansans, most of them with employer plans, had lifetime limits on their coverage.[14]
In addition, tens of millions of people each year nationwide lose job-based coverage and either enroll in individual market coverage or become uninsured. Thus, the availability of affordable, comprehensive individual market coverage is an important protection for Arkansans with employer coverage as well.
Footnotes:
[1]
[2]
[3] All estimates in this section assume consumers face their state average benchmark premium. For the full methodology behind these estimates, see
[4]
[5] Importantly, the bill does not simply fail to provide an appropriation for cost sharing reductions after 2019; it repeals the underlying cost sharing reduction program.
[6]
[7]
[8]
[9]
[10]
[11]
[12]
[13] For a more detailed explanation, see
[14]
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