More than 25,000 older Mainers who have Affordable Care Act insurance could pay up to seven times as much for health insurance under the proposed Republican health care bill under consideration in the House.
Mainers in their 50s and early 60s living in the state’s poorest, most rural counties would be hardest-hit by the Republican bill to replace Obamacare, according to a Maine Sunday Telegram analysis of data from the Congressional Budget Office and the Kaiser Family Foundation, with premiums that could soar from a couple of hundred dollars monthly to more than $1,300 each month.
Ken Voorhees, 61, a self-employed Litchfield builder, earns between $30,000 and $40,000 per year, depending on how much work he gets. He said he currently pays $344 per month in premiums for a plan with a $2,500 deductible. Under the House Republican plan, which would go into effect in 2020 if approved, his premiums could increase to about $900 per month – about one-third of his annual income.
“That would be really tough,” Voorhees said. “I would probably have to go back to working for someone else.”
He said he hopes the proposed House plan fails.
“Fix the ACA instead of playing politics and threatening the health of our country,” he said.
Of the 79,400 Mainers who currently receive insurance coverage through the Affordable Care Act, almost one-third, or 25,391, are between the ages of 55 and 64, the group that experts say would be hit disproportionately hard by the replacement bill.
A county-by-county breakdown of costs shows that premiums for older Mainers in rural areas, where health care costs are higher, could be up to seven times more expensive than their current monthly insurance payments under the Affordable Care Act.
In some cases, 50 percent or more of their annual income would be devoted to health care premiums under the plan touted by House Speaker Paul Ryan, called the American Health Care Act.
For example, a 60-year-old earning $30,000 with an ACA silver plan who lives in Aroostook County would see monthly premiums increase from $208 under the Affordable Care Act to $1,300 when the House Republican plan would kick in in 2020. That’s about half of the enrollee’s income.
MANY WOULD DROP INSURANCE
Maine Sen. Susan Collins, a moderate Republican who on Thursday announced her opposition to the House plan, said such premium increases are untenable for older enrollees who depend on affordable health insurance.
“It is totally unrealistic,” Collins said. “There is no way someone earning $30,000 could afford a monthly premium of $1,300, and on top of that pay for deductibles and co-pays.”
Instead, many would simply drop their insurance altogether. An analysis by the acasignups.net website estimates that about 56,000 enrollees in Maine would do so.
The nonpartisan Congressional Budget Office on Monday released an analysis of the House proposal estimating that 24 million fewer people would have health coverage in 10 years than if the ACA remained, nearly doubling the number of uninsured Americans from 10 percent to 19 percent. The CBO projected that the number of uninsured people would jump 14 million after the first year of the House bill.
Jane Brox, 60, a self-employed author from Brunswick, said she would have to deplete her savings to pay for health insurance until she reached 65, the age at which she would qualify for Medicare.
Brox, who earns about $35,000, said she currently pays about $250 per month for insurance with a $2,000 deductible. Under the House bill, her premiums would jump to about $750 to $800 per month.
“This would all come from my retirement account,” Brox said.
Brox said she always has purchased insurance, but before the ACA, it was increasingly expensive and difficult to afford. She was hit with premiums of several hundred dollars per month and deductibles of $5,000. Brox said she fears a return to those days if the ACA is repealed.
“Since I was spending so much money on insurance, and my deductibles were so high, I would have to be practically keeling over before I would go see a doctor,” Brox said.
Brox said since she obtained ACA insurance, she’s now more likely to get preventive care, such as annual screenings.
OLDER MAINERS HIT HARDER
There are a number of reasons older Americans would be hardest-hit if the ACA were repealed. The House plan does not adjust for income and allows insurance companies to charge older Americans five times what a young person could be charged.
The ACA limits insurance companies to charging those in older age brackets up to three times the cost of a young person.
The House plan also gives a flat tax credit – up to $4,000 to purchase insurance – while the ACA’s tax credits adjust for income and absorb the premium increases for the 85 percent who qualify for subsidies.
As a result, even in Cumberland, York and Sagadahoc counties, where premiums are lower than in more rural parts of Maine, the same 60-year-old would see monthly premiums rise from a couple of hundred dollars to $735 if the Republican bill were approved.
For Mainers in all age groups, the average cost of health care – including premiums, co-pays, deductibles and other costs – would increase by $3,686 per year under the Ryan plan, according to the Center for American Progress, a left-leaning Washington, D.C., think tank.
Rep. Chellie Pingree, D-1st District, asked Mainers who had been helped by the ACA to share their experiences. More than 1,000 people recounted their personal stories, said Pingree, who will host a “health care town hall” from 4 to 6 p.m. Sunday at King Middle School in Portland.
Almost 80,000 Mainers have insurance through the Affordable Care Act’s individual marketplace, where people can purchase subsidized insurance. Subsidies are also available for those earning up to 400 percent of the federal poverty level, or $97,000 for a family of four. The ACA mostly protects those who receive subsidies from premium increases.
By contrast, the Ryan bill gives people up to $4,000 total in tax credits to help pay for insurance based on age, and any premium increases beyond that must be shouldered by the enrollee.
“Everything about this House bill makes things worse,” said Pingree, noting that the Ryan bill ends Medicaid expansion, cuts Medicaid and reduces taxes for the wealthy.
Maine is one of 19 states that have not expanded Medicaid, because Republican Gov. Paul LePage has vetoed several attempts to do so. However, Medicaid expansion will go before voters in a referendum this November.
Ellie Daniels, 63, a midwife from Belfast, said the ACA has been affordable for her, with premiums in the $250-per-month range, and she’s now more likely to use her insurance since she enrolled. She said she will turn 65 before the Ryan bill would become law, so she would not be financially affected unless the health care marketplaces collapse or provisions of the Ryan bill were to begin before 2020.
“I would be paying 30 percent of my income just for premiums (under the House bill),” Daniels said. “I couldn’t afford that.”
Robert Whitehouse, 60, of Brunswick, is a self-employed electrical engineer. He and his wife, Sophie, together earn more than $100,000. He said he stopped working for someone else and started his own business, thanks in part to the ACA, and their combined monthly insurance premium is about $1,900.
SENIORS MAY PUT OFF CARE
One of the benefits of the ACA, proponents say, is that it reduces “job lock,” where people stay in jobs they don’t want, primarily for the health insurance. While the Whitehouses’ household income is too high to qualify for a subsidy, Whitehouse said he still found ACA insurance affordable enough to let him quit and go into business for himself.
Because they don’t qualify for ACA subsidies, the Whitehouses may pay a similar amount for health insurance if the Ryan plan is approved as compared to the ACA. It’s unclear exactly how it would work out for the family, though, because the Ryan plan tax credits phase out for higher incomes.
Even so, Whitehouse said he’s concerned that repealing the ACA would destabilize insurance markets and drive up premiums. Some health experts are predicting a “death spiral” for the individual insurance market if the Ryan plan is approved.
Whitehouse said if individual insurance becomes too expensive, he might have to give up his consulting business for a few years. “How big could these premium increases be? Pretty darn big,” he said. If premium increases became too burdensome, he said he “would have to go back into industry. I would probably have to work in Boston for a few years until I retired.”
The House bill passed a committee vote Thursday, despite opposition from members who said it still doesn’t go far enough in dismantling the ACA. The full House may vote on it this week.
Lori Parham, state director for AARP Maine, which opposes the bill because of its anticipated increased costs for seniors, said the entire health care system would be burdened with extra costs if the House plan goes into effect.
Older people, who tend to get sicker and are more vulnerable to major illnesses, would put off getting health care until their situation becomes acute, she said. That means older Mainers would be less healthy and potentially less financially stable as they approach the age of 65 and get on Medicare, further raising the program’s overall cost of caring for the elderly.
“It’s going to be devastating across the board,” Parham said.
Joe Lawlor can be contacted at 791-6376 or at: