Obamacare GOP Senate cure inflames Florida premiums by projected 69%

June 29--The numbers portray even less of a picnic for older consumers. The Senate bill would raise Affordable Care Act marketplace premiums $6,910 a year for a 60-year-old making $50,000 in Palm Beach County, the Kaiser Family Foundation said. Increase: 135 percent.

"In a very real sense, the Senate bill offers you less coverage and costs you more," said Dave Bruns, AARP Florida communications manager. "That is borne out by the Kaiser Family Foundation data and by our analysis of the bill."

With polling support for the Senate bill hovering around 17 percent, wavering GOP senators forced a delay in a planned vote this week. Majority leader Mitch McConnell, R-Ky., called for a revised plan by Friday that Senators could consider over the holiday.

Others would benefit from the Better Care Reconciliation Act. It cuts close to $1 trillion in taxes for corporations and individuals making more than $200,000 a year. It offers budget savings of $321 billion over a decade, the Congressional Budget Office said.

Younger and higher-income consumers in the ACA marketplace stand to come come out better. A 27-year-old living in Palm Beach County and making $50,000 would save a projected $260 a year on 2020 premiums, for example.

Florida Republican Sen. Marco Rubio's office did not respond to a request for comment on projections for consumer costs in his state. Rubio told reporters in Washington, "The hope is that we can at least have an agreement on what we can get enough votes on this week and turn to it as soon as we come back."

The state's Democratic Sen. Bill Nelson said: "The bottom line is this: the Republicans' health care bill is bad for the people of Florida. It increases costs and decreases coverage. And it allows older Americans to be charged more than younger people."

Here's what the Kaiser Family Foundation found: The average monthly premium that Florida consumers pay on healthcare.gov in 2020 would rise to $237 on a silver plan under the Senate bill, compared to $140 by leaving the Affordable Care Act intact.

That's the bottom-line premium the consumer has to pay monthly after subsidies, or government assistance to lower costs, is figured in, researchers said.

It's a double whammy for a 60-year-old making $20,000 a year. Premiums would more than double to $2,080, and the consumer would also lose by 2020 government help to cover co-pays and deductibles amounting to about $4,800 this year, according to the Kaiser Family Foundation. The consumer would have to make the up the difference.

McConnell has maintained a steady message that Congress must act because Obamacare's status quo is unsustainable. The Trump administration's Department Health and Human Services noted Tuesday that 49 U.S. counties have no insurers for the ACA marketplace in 2018.

"I am deeply concerned about the crisis situation facing the individual market in many states across the nation, "said Centers for Medicare and Medicaid Services administrator Seema Verma.

Meanwhile, the pro-ACA group Center for American Progress projected 2.1 million Floridians will be left without health coverage in 2026 under the Senate bill compared to keeping the Affordable Care Act intact during that span. Those figures include 1.3 million on Medicaid and 817,500 in the individual market, the group said.

Rubio pushed back against such projections on Twitter on Wednesday, saying Florida never expanded Medicaid so it's misleading to make it sound like 1 million will get cut off from Medicaid if the state does not expand the program by 2026.

As long as the amount of federal money that goes to the state is "fair," he said, "no one currently on or eligible for Medicaid should lose coverage."

That still leaves the issue of what is fair if the federal government caps future Medicaid payments to the states under the bill. State and local governments are likely to get stuck with billions of dollars in shortfalls, opponents say. The National League of Cities called it an "unfunded mandate."

Medicaid covers 4 million Floridians, including half the childbirths, 70 percent of seniors in nursing homes and 41 percent of Palm Beach County's children.

The saga of Obamacare replacement has come a long way since President Donald Trump pledged "much less expensive and much better" health care in January.

Senate bill supporters say it protects those with pre-existing conditions, but the bill could let states waive rules in a way that makes coverage much more costly to those consumers, said Michelle Long, policy analyst for the Kaiser foundation's Health Care Marketplace Project. Potential changes include letting insurers reimpose annual or lifetime caps on benefits or opt out of certain "essential benefits" they must cover now, she said.

"I don't see anything in the language to prevent that," Long said.

Waiving such ACA requirements potentially affects millions of Floridians on employer plans, analysts say, not just the 1.5 million with exchange policies and 4 million on Medicaid.

Though it offers more subsidies for low-income consumers than the House bill does, the Senate plan still lets insurers charge older consumers five times as much as younger ones, up from three times now. Advocacy group AARP has staunchly opposed this as an "age tax."

The Congressional Budget Office on Monday projected the Senate bill would leave 22 million Americans without coverage they would have had under the Affordable Care Act by 2026.

On Monday, the American Medical Association announced its opposition to the Senate bill in a letter to McConnell. "Medicine has long operated under the precept of 'first, do no harm.' The draft legislation violates that standard on many levels," said the letter from James L. Madara, AMA's CEO and executive vice president.

Senate bill's effect on Palm Beach Co. premiums

Below is a comparison of annual premiums in 2020 for a healthcare.gov silver plan under the existing Affordable Care Act and the Senate's Better Care Reconciliation Act. Amounts reflect the net amount the consumer pays. It does not include the impact of cost-sharing subsidies, which are eliminated by 2020 in the Senate plan. That means total out-of-pocket costs will rise further for lower-income consumers under the Senate bill than shown here.

Age / Income / ACA premium / Senate premium / Change

60 $20,000 $950 $2,080 Costs $1,130 more

60 $50,000 $5,100 $12,010 Costs $6,910 more

60 $100,000 $8,940 $12,010 Costs $3,070 more

40 $20,000 $960 $1,290 Costs $330 more

40 $50,000 $4,210 $4,210 No change

40 $100,000 $4,210 $4,210 No change

27 $20,000 $950 $1,160 Costs $210 more

27 $50,000 $3,450 $3,190 Costs $260 less

27 $100,000 $3,450 $3,190 Costs $260 less

Source: Kaiser Family Foundation

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