One of the structures that has allowed more than 960,000 Texans to gain health insurance under the Affordable Care Act would be a thing of the past under the Senate repeal bill, the Better Care Reconciliation Act.
Currently, the vast majority of Texans in the market get some help from the federal government to pay for their plans on the individual marketplace created by the ACA, otherwise known as Obamacare. The BCRA would change how much help certain people get in the future, and experts say it could mean fewer people will be able to afford plans in the marketplace.
Elizabeth Colvin, the director of Insure Central Texas, says that since the start of the federal marketplace, her group has helped more than 22,000 people in the area sign up for insurance.
“Most of the people had not been able to get health insurance prior to the Affordable Care Act,” Colvin says. “So they were self-employed. We have also helped people who were excluded from insurance because of preexisting conditions and lifetime caps, and they were not eligible for health insurance.”
Obamacare offset a lot of the costs that had previously kept people from buying insurance.
According to the Kaiser Family Foundation, almost 90 percent of Texans on the Obamacare market get help paying for things like premiums and deductibles. Colvin says it makes a big difference. For example, she says, even someone making $15,000 a year was able to find a plan.
“They could get a plan with a very affordable premium, but then they can have a zero deductible and an $850 out-of-pocket maximum,” she says. “That's phenomenal coverage, and that’s affordable enough for someone to be able to afford it on a monthly basis and to be able to use it.”
This is what would go away under the Senate bill, says Stacey Pogue, a senior policy analyst with the left-leaning Center for Public Policy Priorities.
“What the Affordable Care Act did was make it easier for people who are older or sicker to get health care,” she says. “The people who you would expect would need health care the most got some help accessing it.”
She says poor and older people in the market are going to find it very hard to afford insurance under the Senate plan, while younger and wealthier people will do better.
"The Senate bill undoes that structure, where the people who you would expect would need health care the most – people as they age, people who are the lowest income, the people who are the most vulnerable," Pogue says. "It places health care even further out of their reach."
For example, that person making $15,000 could see a deductible of up to $6,000. What will most likely happen, Pogue says, is that person will drop out of the insurance market altogether.
“They're not going to buy that coverage, because there's no value in paying $200 or $500 a year for coverage when the deductible is half your income,” she says.
Pogue says those costs will just shift to other people.
“You don’t stop needing health care,” she says. “You still show up at a hospital emergency room and the way those costs get absorbed is by providers passing on those costs – raising costs for people with private insurance or local property taxes. Taxpayers at the local level are picking up those costs.”