SALT LAKE CITY (AP) — Utah officials are reviewing how the state would be affected by a plan from Congressional Republicans to replace President Barack Obama's health care law, but local health advocates say it could make coverage unaffordable for older people and the poor.
Gov. Gary Herbert has said the proposal is a "starting point," for a replacement plan, and his office said Tuesday it does not yet know how the proposal would affect Utah's budget.
Nationally, the legislation would cause 14 million people to lose their insurance coverage in the first year, according to an analysis released this week by the Congressional Budget Office. The nonpartisan office estimates the number of people losing insurance by 2026 would grow to 24 million, with a large part of that driven by reductions to Medicaid.
The GOP legislation would use tax credits based on age to help people buy health coverage, phase out extra help to states that expanded their Medicaid programs and cap the program. It would end some requirements for health plans and taxes under the Obama administration's Affordable Care Act.
Utah's Insurance Department and Health Department said they're still trying to figure out how the plan would play out in Utah, especially because the state that did not expand Medicaid as covered under the Affordable Care Act.
But some health advocates say the proposal would leave tens of thousands of Utah's rural residents, older folks and low-income families paying more for coverage.
"A lot of people are going to fall through the cracks," said Jason Stevenson with Utah Health Policy Project, a nonprofit that advocates affordable health care.
Stevenson said those over 40 could see dramatic increases in their monthly premiums because the GOP plan would allow insurers to charge older people up to five times more than they charge young people. They can only be charged three times more under the Affordable Care Act.
Stevenson said the proposal would also drive up costs for most of the 197,000 getting insurance through the online insurance market. About 72 percent of them would have to pay higher costs when seeking care, because the proposal eliminates cost-sharing subsidies that help with deductibles and copayments.
Under the Affordable Care Act, tax credits are based off geography, but the new plan doesn't take that into account, meaning a 25-year-old Alaska man would receive the same amount as a Utah man. Utah has a younger, healthier population where insurance costs tend to be lower than other states like Alaska, where costs are high, or Florida, where the population is older. Stevenson said the flat tax credits could leave Utah relatively well-situated compared to those other states, but it also means that rural residents within Utah could fare worse than urban residents.
Stevenson said the proposal could lower costs for those with higher incomes and for younger people, who could be helped out quite a bit with the tax credits.
Utah's Insurance Department is still reviewing the proposal and does not yet know what it will cost in Utah, according to spokesman Steve Gooch.
Nate Checketts, a deputy director at Utah's health department who oversees the Medicaid program, said his office is reviewing how the proposed changes would play out in states like Utah, which did not expand Medicaid under the Affordable Care Act.
"I'm still trying to make sure I know how all of these pieces fit together," Checketts said.