Now that the Republicans’ long-awaited replacement plan for Obamacare has been revealed, it’s pretty clear why they have been so reluctant to make it public: This is one ugly baby.
In fact, if enacted into law, the GOP plan would strip millions and millions of our fellow Americans of their health insurance, including hundreds of thousands here in Georgia.
Some would be forced to drop their policies because the subsidies that have allowed them to purchase individual coverage will be slashed, and slashed dramatically in many instances. Others would lose coverage as the expansion of Medicaid is rolled back, and as federal funding for traditional Medicaid is cut as well. We have no good estimate on how many millions will be affected — House Speaker Paul Ryan is trying to force the plan through the committee process before the Congressional Budget Office can produce such numbers — but there is no plausible way to make cuts of the proposed magnitude without significant reductions in coverage.
On the other hand, if you’re wealthy, the House plan gives you a lot to smile about. The taxes on Americans making more than $200,000 a year that have helped to pay for Obamacare and that make it deficit-neutral at worst would be rolled back under the House plan, producing an average tax benefit of $165,000 a year for those in the top 0.1 percent, according to the Tax Policy Center.
And if we don’t have CBO numbers yet, we do have other tools by which to gauge the impact of this plan. The Kaiser Family Foundation, for example, has created a database allowing a county-by-county analysis of the impact of the House plan for individuals in various age and income groups.
Let’s say that you’re a 60-year-old who makes $40,000 a year in Union County and its county seat of Blairsville, along Georgia’s North Carolina border. Under Obamacare in 2020, Kaiser data says, you would get a subsidy of $9,130 to help you buy insurance, compared to just $4,000 under the House plan. That’s an increase of $5,130 in your out-of-pocket expense for health insurance, and for a person at that income level, that simply isn’t affordable.
It gets worse. Under Obamacare, insurance companies can charge our 60-year-old friend a maximum of three times as much as it charges a young customer. Under the House plan, that multiple jumps to five times as much. So as the subsidy drops for older Americans, the cost of similar coverage will increase.
The impacts will extend well beyond the individual to the communities in which they live. For example, when that 60-year-old Blairsville resident drops insurance as unaffordable, he or she is no longer a paying customer for the local health-care system and in fact becomes a financial burden due to uncompensated care. The already difficult financial situation for rural and small-town hospitals and doctors will worsen, and it will worsen again as Medicaid cuts further reduce their base of paying customers.
In many of these places, the meth and opiate epidemics are taking a vicious toll, and without insurance, drug-treatment options disappear. Just last year, three local doctors, including the CEO of Union General Hospital in Blairsville, were arrested and charged with running a prescription drug ring for oxycodone and other opiates.
Oh, and one other thing. In the 2016 elections, 81.6 percent of Union County voted for Donald Trump, the man who promised repeatedly that under his Obamacare replacement plan, nobody would lose insurance coverage.