WASHINGTON – Some low-income Ohioans would see their federal assistance shrink under the House Republican plan to replace Obamacare, while more affluent and older state residents would receive greater help in paying for health insurance, according to a new analysis of the GOP bill.
The impact of the Republican plan would vary dramatically across the state, depending on an individual’s age, income, and county of residence, according to the Kaiser Family Foundation, a nonpartisan health care organization. The estimates show how individuals would fare under the Affordable Care Act versus the Republican plan in 2020.
The analysis shows, for example, that in Hamilton County, a 60-year-old with an income of $20,000 would see their federal tax credit drop by 35 percent under the GOP proposal. A 27-year-old with that same income would see receive 11 percent more in tax credits to cover the cost of insurance.
A person who is 40 years old and earns $20,000 would see the value of their tax credits increase by 24 percent — from a $2,410 credit under the Affordable Care Act to $3,000 under the GOP plan. Someone the same age — 40 — and earning $75,000 would receive no assistance under the ACA but would get a $3,000 tax credit under the GOP plan.
The KFF analysis does not include cost-sharing assistance under the ACA, which lowers deductibles and copayments for low-income marketplace enrollees, so poorer Ohioans would probably be more negatively affected than this analysis suggests.
The Republican plan is drawing mixed reviews from Republicans and strong opposition from Democrats, underscoring just how difficult it will be to pass the legislation.
The ACA provides tax credits to individuals and families based on income the cost of health insurance in their local market, so older people who face higher premiums for coverage get larger tax credits. The GOP alternative offers refundable credits that become more generous with age. The credits phase out at higher income levels, but in many cases, wealthier individuals would still benefit more under the GOP plan than under the ACA because the ACA offers no help for more affluent Americans.
Some of the most conservative Republicans have warned that the GOP replacement bill's tax credits would be just another entitlement program.
"I don’t think we promised the voters we’d repeal it ... but start a new entitlement with a fancy name of ‘advanceable refundable tax credits,' " Ohio Rep. Jim Jordan told USA TODAY.
Jordan also said the GOP plan did not move quickly enough to nix the Medicaid expansion. Ohio Gov. John Kasich has embraced the Medicaid expansion and noted that has allowed 700,000 low-income Ohioans to gain coverage, leading to improved health outcomes and more financial stability.
Kasich had repeatedly warned against drawing back Obamacare's Medicaid expansion. His office could not immediately provide analysis of the effects of the GOP's repeal bill on Ohio's health care system.
Sen. Rob Portman, R-Ohio, and several other Republican senators expressed concern that an early draft of the bill had not provided enough “stability and certainty” for families covered by the Medicaid expansion. They said any replacement plan should offer a “stable transition period and the opportunity to gradually phase-in their populations to any new Medicaid financing structure.”
It was not immediately clear whether the bill unveiled Monday night would put those concerns to rest.
Cincinnati Enquirer reporter Chrissie Thompson and USA TODAY reporters Maureen Groppe and Eliza Collins contributed to this story.