Older New Hampshire residents would see higher health care premiums under the House-passed Republican health care plan, but younger people would see significant reductions, according to projections made by an organization that tracks health- and insurance-related issues.
Recently, the Kaiser Family Foundation compared projected premiums in 2020 under both the Affordable Care Act and the American Health Care Act , which passed the U.S. House earlier this month.
Some of the differences are stark. For example, low-income 60-year-olds could see AHCA premiums of $6,700 more than six times higher than under Obamacare.
“It’s hitting those that are hit the hardest by so many other factors,” said state Sen. Jeff Woodburn, D-Whitefield. “Those with the least resources, the least opportunity, are getting hit the hardest.”
But New Hampshire 27- and 40-year-olds in all categories, whether poor or middle class, would see substantial reductions in premiums, according to the projections.
Middle-income 40-year-olds, for example, would see their premiums tumble to $770 under the Republican plan, about a fifth of what they would pay under Obamacare.
The reductions help young people, who are struggling with college loans, housing costs, or young families, according to Greg Moore, state director of Americans for Prosperity. Under Obamacare, they pay hefty health insurance premiums when they’re not making a lot of money and don’t need a lot of health care, he said.
“Older people, yes, they tend to have more medical needs, but they tend to make more money,” Moore said.
Both Moore and Woodburn cautioned that both health plans deal with more than just the premiums on the HealthCare.gov exchange, where individuals can purchase insurance, often with a government subsidy if they qualify.
Woodburn said the Republican plan could threaten Medicaid expansion, just when New Hampshire needs it to provide treatment for opioid addiction.
Moore said the projections don’t apply to employer-provided plans, which is where most people get their health coverage.
In New Hampshire, the health insurance market is relatively healthy, with four insurers in the HealthCare.gov exchange and relatively low premium increases, the state Insurance Department said in emailed answers to a list of questions.
“However, there is significant uncertainty now about what the market environment is going to be in 2018 and beyond, including whether cost-sharing reductions will be fully funded by the federal government. In addition, there are significant inflationary pressures on premiums, most notably the growth of medical and pharmaceutical costs,” the department said.
As of April, 91,671 New Hampshire individuals obtained health coverage through HealthCare.gov, according to the Insurance Department. Of those, 43,434 participated through Medicaid expansion.
In making its projections, Kaiser Family Foundation relied on Congressional Budget Office projections and took factors for many states into account, such as the pricing and costs of premiums. Other factors could not be considered, such as whether states would seek waivers for items such as essential health benefits, community rating and pre-exisiting conditions.
A key reason for the different premiums is age curves the amount of variation in premiums that insurers allow based on a person’s age, Kaiser said. Under Obamacare, age ratings could only vary by a ratio of 3:1, meaning the oldest insured person wouldn’t have to pay more than three times the premium of the youngest.
Under the Republican plan, that ratio changes to 5:1.
Before the ACA, the New Hampshire insurance market could use several factors to set premiums: age, industry, geographic location and tobacco use. In theory, the total variation allowed in the individual market was 6.75:1, the Insurance Department said.
The Insurance Department is seeking bids from consultants to develop macroeconomic models on the probable impact of a number of possible changes in health care, the department said.
Last year, 66 percent of New Hampshire people who were enrolled in a plan on the Obamacare exchange qualified for a tax credit to reduce their premiums. That was the lowest percentage in the country, according to statistics compiled by the U.S. Department of Health and Human Services.
New Hampshire premiums rose only 2 percent on the exchange between 2016 and 2017, one of the lowest increases in the country.
Date:May 13, 2017