A Map That Plots The Effects Of Republican Obamacare Replacement

Mar 16, 2017

Cover image of the American Health Care Act
Credit US Congress

We now have a sense of what the American Health Care Act could cost North Carolinians.

The AHCA is the Republican plan to replace the ACA – otherwise known as Obamacare.

MT:  This all has to do with money and a map.

TB: And one of the key differences between Obamacare and the Republican replacement plan. Both are based on formulas, so you can extrapolate results.

Currently, Obamacare gives subsidies to individuals or families that qualify in order to help pay their health insurance premiums. The size of the subsidies depends on income, age and the actual cost of coverage which varies based on where someone lives. This can grow to more than $16,000 in Mecklenburg County for instance.

The Republican plan replaces that with a subsidy, specifically a refundable tax credit based simply on age. This ranges from $2,000 to $4,000.

So that's the money. Here's where the map comes in.

Credit Kaiser Family Foundation

Using all this data, the Kaiser Family Foundation plotted out a map of every county in the country. They then set up filters for their digital map based on age and income. This lets us see their estimate of what the Republican plan would cost North Carolinians in 2020. Marshall, it's important to note Kaiser's estimates are not the final word on this. Their calculations don't take into account a number of other factors that contribute to the size of Obamacare subsidies, and they don't take into account people who don't qualify for the GOP plan's refundable tax credit. But it does still allow us to look at how some of the numbers shake out. 

MT: Let's walk through those estimates starting here in Mecklenburg County.

TB: The Kaiser Foundation numbers estimate that here, like in other parts of the country, more affluent people fair better than poor people under the Republican plan.

A 60-year-old in Mecklenburg County making $100,000 a year would get no subsidy under Obamacare. But they would get a $1,500 tax credit towards health care under the replacement. If that same 60-year-old makes $75,000, they would do even better since they qualify for the full $4,000 tax credit. And they would have received no subsidy under Obamacare.

But as you go down the income ladder the situation changes.  

Under Obamacare, if that same 60-year-old made $50,000 a year, roughly the median income in Mecklenburg County according to the census, they would receive $12,000 in subsidy. But under the GOP plan they would get just $4,000. So that's a drop of $8,000 or roughly 67%.

That dropoff is most significant at the lowest incomes. Think of a retiree making $20,000 a year. They would see their subsidy drop by $12,000 or 75%.

And Marshall, I'm focusing on 60 year olds in this scenario because older people use more health care.

MT: So that's Mecklenburg, what about other counties?

TB: In rural counties, say Catawba, the cost of health care coverage is lower. But the situation is similar. A 60 year old making $20,000 in Hickory would see their subsidy drop by 71% according to Kaiser's calculations.

MT: What about younger people?

TB: A 40 year old making $50,000 in both Catawba and Mecklenburg Counties would actually get a bit more in subsidies under the republican plan. About $20 more in Mecklenburg and more than $1,000 more in Catawba.

But if they make $30,000, which means they have less to spend on premiums overall, they would lose out on $1,500 to $2,600 a year to cover those costs.

MT: The Obamacare replacement bill is facing a tough fight in the US House. Where do our Representatives stand on the bill?

TB: Party line on this one, Marshall. Republican Representatives Richard Hudson, Robert Pittenger and Patrick McHenry are in favor of the plan. Democrat Alma Adams is against it.

North Carolina Senators Thom Tillis and Richard Burr have yet to make firm statements on the Obamacare replacement plan. Though both voted in favor of repealing Obamacare in the past.