How will Floridians fare under the American Health Care Act (AHCA)? Jeff Johnson, the state director for AARP Florida, says: not well. Johnson also says Floridians on Medicaid – especially those in nursing homes – might be harmed by the AHCA.
Listen to the story here:
“Well, there are a couple of things, particularly from AARP’s perspective that we have some concerns about. As you may know, Florida is one of the states that has the highest enrollment in the current Affordable Care Act exchanges for individual health insurance. And the changes that are in the AHCA include a shift from the current subsidies that are given to people who just need premium support–they need help paying for their premiums for their individual insurance plans–that’s going to shift to a tax credit that is in the AHCA. That shift, in terms of how it’s given is one thing, but, in some ways our graver concern is that the subsidies that’ll be provided, in place of the current framework, won’t be sufficient. Particularly for those who are older, between 50 and 64.
“So, we’re not talking about Medicare eligible folks: 65 and over. We’re talking about people who are still very much in the workforce, who are trying to balance kids and grandparents and everything in between and we’re seeing a shift in structure that is really going to disadvantage them.
“So, I mentioned that the shift from subsidies to tax credits is one that is not going to leave them in the same position that they currently are, with the Affordable Care Act, in terms in the affordability of insurance. But, in addition to that, there is a provision within the House healthcare plan that would enable insurers to overcharge people solely based on age, up to 5 times more.
“So, if you’re in your 60s, you may be just as healthy as somebody in their 20s and yet you’re gonna pay 5 times more in premiums. For folks, particularly who are low to middle-income, that’s going to be devastating. There’s analyses that show if you’re a 60-something, who’s making about $25,000-$35,000 a year, you could be paying as much as half of your income for health insurance premiums in the new regime. This is a major focus that we’ve been talking about in the last couple of weeks and it’s something, certainly, that we’re watching as this goes through the legislative process.”
And your group, the AARP, is calling that an “age-tax?”
“Yeah, that’s right. That shift from current law, actually–insurers can discriminate, based on age, at a 3-1 level–so that shift from 3-1 to 5-1, which could be $3,000 a year in addition just for health insurance premiums, we’ve called the “age-tax” because it is solely based on age. And it’s unconscionable for people, who again, are just barely making right now, to have to look at a increase in premiums that’s that substantial.”
Another affect of the AHCA, the American Health Care Act, that’s being proposed is that Medicaid could be slashed. How would that affect seniors, especially people in nursing homes?
“Thank you for asking that, because, while we have been focused on the age-tax and we’ve been focused on the 50-64 population and the Medicare population has only kind of downstream effects of this legislation. It would shorten the life expectancy of the Medicare trust fund for the Medicare Part-A, by a few years.
“The Medicaid issue is one that is very top of mind for us, and should be especially here in Florida, because the primary financing mechanism, if you will, of the changes that this plan would enact is to cut about $800 Billion out of the Medicaid program and turn it into a program that is essentially instead of the current Federal-State matching program, where federal tax revenues go in, state tax revenues go in, and together they fund the program. In this case, the federal portion would be capped: would either be limited per person or just in a block grant that would be turned over the states to do with as they will.
“Our concern on that is this: certainly while Florida has a very large baby-boomer population that’s in their 50s and 60s, we also have folks who are their parents, who are in need of long term care and most people would prefer to get that care at home, but, we have a waiting list in Florida of 60,000 people who are eligible for long-term care services at home, but, we just don’t have the slots to put them in in the current Medicaid program. If we cap the Medicaid payments from the federal government even more dramatically, that means that even more of those people are going to have to choose between whether or I want to go in a nursing home or I’d rather not be in, which is frankly, more expensive for the state and for us or would I rather just die in my home for lack of services.
“Unfortunately, last year, we lost about 5,000 Floridians who took that latter choice; who were on the wait list for services they needed and passed away before their number ever got called. Certainly, our concern is that if cuts to Medicaid are made at the federal level, it will roll down to the state level in a way that will hurt folks, perhaps those who are in nursing homes, certainly those who are waiting for the services that they need in their home.”
Is there anything else our listeners should know about the AHCA?
“Well, I guess what I’d say is this: this is a fast moving legislative proposal, certainly by congressional standards and I think it’s really incumbent upon listeners to keep an eye on things as they move. I know, just in the last day or so, there have been some talk about the House adding some provisions that would help on that subsidy/age-tax proposal, but, right now it’s just talk. So, we’ll have to see what actually plays out there.
“And I commend you for raising the Medicaid issue and I certainly hope that if your listeners are affected by Medicaid, if they have loved ones who rely on Medicaid for services, that they’re doing everything they can to make sure that not only their member of congress knows how important that program is, but, that their state legislators know as well.”
During a closed-door meeting at the U.S. Capitol Tuesday morning, President Donald Trump warned House Republicans that they risked losing re-election next year if they don’t support a bill to repeal and replace Obamacare. That comes from a New York Times story on the bill.
The House is scheduled to vote on the bill Thursday. If it passes, the bill faces an uncertain future in the Senate.
Information from the Associated Press was used in this report.
Here’s the Kaiser Family Foundation interactive map comparing tax credits under ACA vs AHCA.