Tagged Uninsured

How Millennials Win And Lose Under The GOP Health Bill

Designing skateboards is just one of Luke Franco’s gigs. On a recent afternoon, he had just enough time before his next shift to chat at a café in downtown Providence, R.I.

“I work at the YMCA Monday through Friday with kindergartners through fifth-graders. It’s split shift; 7 to 9, 2 to 6 daily,” he said. “With the rest of my day, I also work at a local pizza place. And in addition to that, I also own and operate a small skateboard company.”

But none of his jobs comes with an offer of health insurance. Does that worry him?

“Yes, especially being an avid skateboarder,” the 26-year-old said. “That’s constantly something in the back of my head now — before I try this trick, what happens if I get hurt?”

So he’s looking for a full-time job with benefits. Beyond that, Franco hasn’t fully explored his insurance options. He’s a member of the millennial generation. They represent more than a quarter of the nation’s population. These are people loosely defined as 18 to 34 years old, and they figure prominently in the health care debate. How they fare under the GOP health care bill going through Congress is complicated.

Franco doesn’t know whether he qualifies for Medicaid or a subsidy to buy coverage on the exchange set up under the Affordable Care Act, also called Obamacare.

“I’m assuming that paying full price for it [health care] would be completely unaffordable for me,” he said.

The GOP plan would offer Franco a tax credit of $2,000 a year — that’s the flat amount available to 26- to 29-year-olds to help them buy insurance. The amount goes up to $2,500 for those ages 30 to 39. But even if Franco could buy a plan for a few hundred dollars a month, he doesn’t want to. He would rather hold on to what little pocket money he has for dinner or drinks with friends.

Jen Mishory heads an organization called Young Invincibles, a tongue-in-cheek name for millennials who think they’re too healthy to need health insurance. But the organization is serious about advocating for young people. Mishory said the ACA helped this generation.

“You’re starting pre-ACA with an uninsurance rate of about 29 percent for young people. We see that uninsurance rate drop, over the course of the last five, six years to about 16 percent,” she said. That’s due to many factors, the expansion of Medicaid, for one, and children being able to stay on their parents’ insurance until age 26. That’s how Franco was insured until his last birthday.

But coverage on the exchange is still expensive for some millennials. Even with subsidies, they didn’t sign up for the ACA exchanges in the numbers insurers were hoping for.

Mishory points out the GOP proposal to roll back Medicaid expansion could hurt some young, single adults. The proposed tax credit might help others.

“For some young people, [the tax credit] may be more than what they received under the ACA,” she said. “But for a lot of the low-income young people, they could see reductions in that subsidy.”

What concerns Mishory most is the Republican provision that insurance companies could charge customers 30 percent more for a plan if their coverage lapses.

“Young people are the most likely to see gaps in coverage,” she said. That’s because young adults move and change jobs a lot. They also tend to have lower incomes [than their elders], so the penalty might discourage millennials, especially healthy ones, from enrolling in coverage again.

Molly Tracy, 25, is in a different category than Franco: She’ll buy insurance, penalty or not. But she worries the Republican model won’t be affordable.

“I’m not rich! I work in public education,” said Tracy, who works in a charter school. “So even if I do have coverage, having a $3,000 medical bill … that’s going to pose a significant challenge for me.”

Right now, Tracy is covered by her father’s health insurance. But her 26th birthday is coming soon, “so I’m trying to get a tonsillectomy before my insurance lapses. That’s one of the issues. The other issue is scheduling, having enough time to recover.”

When Tracy does get her own health insurance through work this fall, she wants to know what she will be getting. Will birth control remain affordable? Will mental health care be covered? A Congressional Budget Office analysis finds that people like Tracy might end up paying much more out-of-pocket for those benefits than they do now.

This story is part of a partnership that includes Rhode Island Public Radio, NPR and Kaiser Health News.

Categories: Cost and Quality, Insurance, Repeal And Replace Watch, The Health Law, Uninsured

GOP Caught Between Holding Line On Core Beliefs And Appeasing Voters Who Put Trump In Office

There’s a lot at stake politically for the lawmakers who are working to push the replacement plan through Congress.

The New York Times: G.O.P.’s Health Care Tightrope Winds Through The Blue-Collar Midwest
James Waltimire, a police officer on unpaid medical leave, has been going to the hospital in this small city twice a week for physical therapy after leg surgery, all of it paid for by Medicaid. Mr. Waltimire, 54, was able to sign up for the government health insurance program last year because Ohio expanded it to cover more than 700,000 low-income adults under the Affordable Care Act. He voted for President Trump — in part because of Mr. Trump’s support for law enforcement — but is now worried about the Republican plan to effectively end the Medicaid expansion through legislation to repeal the health care law. (Goodnough and Martin, 3/19)

Politico: Ryan Stakes It All On Obamacare Repeal
Speaker Paul Ryan and President Donald Trump — those awkward, sometimes reluctant allies — face the biggest test yet of their unusual relationship as the House barrels toward a dramatic vote this week on repealing and replacing Obamacare. The stakes could not be higher for either of them. (Bresnahan and Bade, 3/20)

The Hill: Ryan-Aligned Group Pressures Vulnerable Republicans To Support Healthcare Bill 
A group allied with House GOP leaders is targeting Republicans in competitive House districts with an ad campaign ahead of a potential vote this week on legislation to repeal and replace the healthcare law. American Action Network (AAN) is launching digital ads on Monday through video, display ads and landing pages urging lawmakers to support the GOP leadership-backed bill, titled the American Health Care Act. (Marcos, 3/20)

Roll Call: Advocacy Group Targets 29 Republicans Ahead of Health Care Vote
An advocacy group with close ties to House leadership is launching a final push to pressure 29 Republicans to support the GOP health care plan ahead of an expected vote later this week. Some of those lawmakers have indicated they won’s support the bill. The six-figure digital campaign comes from American Action Network, the issue advocacy organization that has already spent more than $10 million in 75 congressional districts in support of Republicans’ plan to repeal and replace the 2010 health care law. (Pathé, 3/20)

Politico: Brat: ‘There’s Primaries Coming’ Off Obamacare Repeal
If he were still Professor Dave Brat, he’d call the course he might teach about the last couple of months in Washington, “A Primer in Chaos Theory.” But he’s Congressman Dave Brat, and instead he’s been sowing some of that chaos himself. And he’s nowhere near done helping lead the intra-Republican revolt against the Obamacare repeal bill pushed hard by House Speaker Paul Ryan and President Donald Trump. He’s already predicting conservative insurgents will primary GOP incumbents over the health care fight. (Dovere, 3/20)

The Associated Press: Chaffetz’ IPhone Gaffe Lands Him Well-Funded Utah Challenger
Rep. Jason Chaffetz has strolled to four easy re-election wins in his Republican-friendly Utah congressional district, but now he’s facing a surprising challenge from a Democratic political newcomer who raised nearly a half million dollars — by tapping into anger over Chaffetz’ recent comment suggesting people should spend their money on health insurance instead of iPhones. Dr. Kathryn Allen has been transformed from a political unknown into a liberal hero for calling out Chaffetz on Twitter, giving her an early boost in name recognition ahead of the November 2018 election. (McCombs, 3/17)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

CBO Report Shines Stark Light On Just How Much Wealthiest Will Benefit From Repeal Plan

The plan offers billions of dollars’ worth of tax cuts to health insurers, pharmaceutical companies, investors and even tanning salon operators — amounting to nearly $1 trillion over a decade. Meanwhile, The Washington Post fact checks claims about the medical device tax.

The New York Times: One Certainty Of G.O.P. Health Plan: Tax Cuts For The Wealthy
The House Republicans’ plan to replace the Affordable Care Act is messy and confusing. No one is sure exactly how Americans will be affected and how much more health insurance will cost them. But there are two certainties. Their health care plan provides a tax cut for the wealthiest Americans. And it will make it easier for Republicans to pass more tax cuts this year. It could also be viewed by some people as a break from some of the populist campaign promises President Trump made to lift up the country’s “forgotten men and women.” (Rappeport, 3/15)

The Associated Press: GOP Health Plan: Tax Cuts For Rich; Hits Older People Hard
The House Republican health care plan backed by President Donald Trump provides billions of dollars in tax cuts for wealthy families and insurance companies, but it hits older Americans hard with higher insurance premiums and smaller tax credits. In all, the bill provides $883 billion in tax relief by repealing almost all of the taxes enacted under President Barack Obama’s Affordable Care Act, according to estimates by the nonpartisan Joint Committee on Taxation, the official tax scorekeeper for Congress. (3/16)

CQ Roll Call: Obamacare Replacement Looks Like A Tax Cut To Some
Senate GOP leaders see a silver lining in the contentious House Republican health care legislation: an ambitious tax cut of $883 billion. Majority Whip John Cornyn of Texas was among the senior Senate Republicans who said the Congressional Budget Office projection that taxes would be reduced by nearly $883 billion over 10 years, plus the bill’s attempt to curb Medicaid, could attract support for legislation aimed at repealing parts of the 2010 health care overhaul (PL 111-148, PL 111-152). (Ota, 3/15)

The Washington Post Fact Checker: The Claim That The Medical-Device Tax Led To The Loss Of 20,000 U.S. Jobs
The GOP replacement for the Affordable Care Act would repeal most new taxes in the current health-care law, or Obamacare. Among those taxes is the 2.3 percent medical-device tax, which has faced criticism from both Democrats and Republicans. Lawmakers have attributed all sorts of negative impacts to this law, and we’ve fact-checked some of those claims in the past. A two-year moratorium of the tax, which took effect in 2013, started in December 2015. (Lee, 3/16)

Media outlets also report on how the plan will affect the states —

Seattle Times: 700,000 Washingtonians Would Be Uninsured Under GOP Health Plan, Inslee Says
Washington state would have to come up with more than $2.5 billion a year to pay for losses in Medicaid coverage expected a decade from now under the GOP health-care plan, said Gov. Jay Inslee in a Wednesday news conference. It’s that or 600,000 Washingtonians would lose insurance they gained under Obamacare, said Inslee, as he and state Insurance Commissioner Mike Kreidler added details to their earlier analyses of the GOP plan. (Young, 3/15)

Arizona Republic: GOP Health Bill Would Cut Nearly $47 Million In Arizona Public Health Funds
Arizona could lose $46.8 million in federal public health funding over the next five years via a cut included in the House Republican health bill, likely forcing local health departments to reduce or cut public health programs. While debate over the GOP’s American Health Care Act largely focuses on how the bill seeks to remake private-sector insurance and the Medicaid program for low-income and disabled people, a less-publicized provision would eliminate a Centers for Disease Control and Prevention fund of nearly $1 billion that sustains public health programs nationwide. (Alltucker, 3/15)

WBUR: What The House GOP Health Bill Would Mean For Mass.
At least half a million Massachusetts residents are among the 24 million Americans who the nonpartisan Congressional Budget Office (CBO) says would no longer have health insurance by 2026 under the House GOP plan to repeal and replace Obamacare. The plan’s key architect, Speaker Paul Ryan, says many Americans would be choosing to end coverage because they will no longer be forced to buy it. But many Massachusetts residents say they would not have a choice; they’d be forced to drop coverage because it would not be affordable. (Bebinger, 3/15)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

CBO Estimates That Millions Would Lose Health Insurance Coverage Under GOP Repeal Plan

Mar 13 2017

The Congressional Budget Office releases its anticipated analysis of the American Health Care Act, Republican’s replacement plan for the Affordable Care Act.

The Atlantic: CBO: 24 Million Fewer People Would Have Health Insurance By 2026
The Republicans’ effort to pass their proposed replacement for the Affordable Care Act just got a whole lot harder. The Congressional Budget Office on Monday projected that the House leadership’s American Health Care Act would result in 24 million Americans losing their health insurance while raising premiums for those covered on the individual market. Their bill would lower federal deficits by $337 billion over 10 years, largely as a result of cuts to Medicaid that would reduce its enrollment by 14 million, according to the estimate. (Berman, 3/13)

CNN: CBO Report: 14 Million Fewer Insured By 2018 Under GOP Health Care Law
Fourteen million more Americans would be uninsured under the House Republican health care bill than under Obamacare in 2018, the non-partisan Congressional Budget Office said Monday. The long-anticipated score immediately puts the writers and supporters of the GOP Obamacare bill on the defensive. It is also certain to complicate the party’s already troubled efforts to repeal and replace the Affordable Care Act. (Lee, 3/13)

The Hill: CBO: Millions Would Lose Coverage Under GOP Healthcare Plan
The long-awaited analysis from the nonpartisan congressional scorekeeper is sure to shake up the debate over the measure, which is already facing sharp criticism from conservatives and many centrist Republicans. The GOP bill repeals ObamaCare’s subsidies to buy coverage, replacing them with smaller tax credits, as well as the law’s Medicaid expansion after 2019. Both moves were expected to lead to coverage losses. (Sullivan, 3/13)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.