Here’s who benefits least and most in Maine under the Senate health bill

If you’re a 60-year-old in Maine, you’ll pay higher health insurance premiums on the marketplace if the U.S. Senate’s plan to replace Obamacare passes, no matter where in the state you live or how much you make.

But you’re in for an eye-popping $15,900 increase in annual premiums if you earn $50,000 at that age and you live in Aroostook, Washington, or Hancock counties. Under Obamacare, you pay $5,100 in premiums every year for a middle-of-the-road plan, or $425 a month after tax credits kick in. Under the Senate’s Better Care Reconciliation Act, you’d pay $21,090, or $1,757 a month, with no tax credit to soften the blow.

If you’re a spry 27-year-old, on the other hand, you’ll generally pay less, especially if you earn at least $40,000 a year and live south of Augusta. Young adults in Lincoln County who make that much, for example, would see their premium drop from $4,080 a year, or $340 a month, to $2,710 a year, or $225 a month, after tax credits.

But if you’re a low-income 27-year-old, your premiums are headed up regardless of which county you call home.

(That is, if you decide to buy marketplace insurance at all, since the Senate bill abolishes the Obamacare requirement that all Americans have coverage.)

Thanks to the BDN’s Darren Fishell for the chart wizardry.

Those are the findings of a new analysis by the Kaiser Family Foundation, which projects the premium amounts for 2020, when the Senate bill’s tax credit and premium provision take effect. The premiums are the monthly costs, added up to annual amounts, for a silver plan on the insurance marketplace created under Obamacare. Silver plans are by far the most popular in Maine and across the country, offering a middle ground between bare-bones bronze plans and more expensive gold plans in terms of costs and covered benefits.

The analysis looks at people who buy their own insurance in the “individual market,” as opposed to those who get it through work or government programs such as Medicaid and Medicare. In Maine that totaled about 80,000 people last year, a relatively small percentage of the total population.

A man looks over the website. REUTERS|Mike Segar

Both Obamacare and the Better Care bill provide tax credits to help people afford their premiums. But Better Care provides them to fewer people, partly by lowering the qualifying income limit. Under Obamacare, a family of four could earn up to $97,200 and still qualify for the financial help. That would drop to $85,050 under the Senate bill.

Unlike Obamacare, the Senate bill would make people earning below the poverty line eligible for the tax credits. But the nonpartisan Congressional Budget Office says even with that assistance “few low-income people would purchase any plan” because coverage would become so expensive.

The Senate bill also changes how the tax credit amounts are calculated. On average, younger people would fork over a lower share of their income to buy a plan than they do today, while older people would pay a higher share, according to Kaiser.

The bill additionally reduces the value of the health plans that are used as a benchmark to determine the tax credit amounts. The effect of that change is that plans would pay for a lower share of an individual’s health care costs, meaning deductibles and co-pays would be higher. That’s of particular concern to critics of the bill because Better Care would also eliminate another Obamacare subsidy that helps low-income people pay for such out-of-pocket costs.

Under the Senate bill, states could also waive consumer protections under Obamacare that require insurance companies to charge both healthy and sick people the same premiums. States would have the freedom to opt out of Obamacare rules that require insurers to provide certain health benefits, so insurers could cover less even if their plans cost more, critics say.

Senate Majority Leader Mitch McConnell listens during a meeting with President Donald Trump on June 6, 2017 in the Roosevelt Room of the White House in Washington, D.C. (Olivier Douliery/Abaca Press/TNS)

The latest buzz on the Senate health bill is that Senate Majority Leader Mitch McConnell wants to send a revised version to the CBO as soon as Friday, in hopes of securing a better score by the time lawmakers return to Washington in mid-July, the Washington Post reported Wednesday. Last week, the CBO found that 22 million more Americans would lose insurance over the next decade if the bill passes.

Both Maine U.S. Sens. Susan Collins and Angus King have said they don’t support the bill.




Jackie Farwell

About Jackie Farwell

I'm the health editor for the Bangor Daily News, a Bangor native, a UMaine grad, and a weekend crossword warrior. I never get sick of writing about Maine people, geeking out over health care data, and finding new ways to help you stay well. I live in Gorham with my husband Nick and our hound dog Riley.