For most of the estimated 1.7 million Floridians enrolled in an Affordable Care Act plan, the House Republican proposal to repeal and replace the health law known as Obamacare will change the financial aid they receive to pay their monthly premiums beginning in 2020.
Both Obamacare and the American Health Care Act unveiled this week by House Republicans include financial aid, in the form of tax credits, to help people buy insurance. But the law and the proposed bill calculate those amounts differently. The ACA tests family income, the local cost of health insurance, and age and smoking status to calculate financial aid. The proposed bill bases tax credits only on age, with a cutoff for individuals who earn more than $75,000 a year ($150,000 a year for families).
In Florida, about 1.4 million people or more than 93 percent of those enrolled in an ACA plan for 2016 received financial aid that lowered their monthly premium, according to the Department of Health and Human Services. The average monthly tax credit for those Floridians was $305.
But starting in 2020, that number of people who receive a tax credit, and how far that financial aid goes in lowering their monthly premiums, would change under the Republican proposal, according to analysis of the plan by the nonprofit Kaiser Family Foundation, a health policy think tank.
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In general, Floridians who are older, those with lower incomes and those who live in rural areas will fare worse under the AHCA than they did under Obamacare, the Kaiser analysis shows, while those who are younger, with higher incomes and who live in urban areas will be better off.
However, the Kaiser data reflects only changes to financial aid for monthly premiums. It does not include additional financial aid under the ACA that lowers deductibles and co-payments for very low-income people — a subsidy that the Republican proposal would repeal.
The Kaiser analysis also does not account for differences in plan deductibles and other out-of-pocket expenses, or for the new premium increases for older Americans allowed under the Republican proposal.