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A group fighting against the Affordable Care Act repeal says that House Republicans voted for a health care bill that would lead to skyrocketing costs for older consumers.
"Congressman Curbelo just voted for a disastrous health care repeal bill opposed by the American Medical Association, AARP and the American Cancer Society. Curbelo voted to raise your costs and cut coverage for millions, to let insurance companies deny affordable coverage for cancer treatment and maternity care, and charge five times more for people over 50. Curbelo voted yes even though the bill makes coverage completely unaffordable to people with pre-existing conditions," the ad claims.
The same ad also attacks U.S. Rep. Brian Mast who represents Florida’s Treasure Coast and members in many other states, including moderates who could face tough re-election campaigns in 2018. The ad is largely digital but in some districts it will appear on TV.
Formed in 2016, Save My Care is affiliated with Eric Kessler, a former White House appointee, helping to manage conservation issues during Bill Clinton’s administration. It operates out of the same office as the New Venture Fund, a 501(c)(3) that launches projects related to global health and other areas.
There were a lot of claims to check out from the ad, but we wanted to know whether the bill allows insurance companies to "charge five times more for people over 50."
One provision jumped out right away: Insurance companies could charge five times more for those ages 50-64 buying insurance on the individual market.
Some viewers might assume the five-fold increase starts from zero.
What the ad doesn’t tell you is that insurers can already charge older people more than younger adults — three times as much.
Age ain’t nothing but a number (but it could make insurance more expensive)
For this fact-check, we’re looking at what the proposed House health bill does about older adults between ages 50-64 on the individual health insurance market.
So this doesn’t apply to seniors on Medicare, or people between 50 and 64 years old who have employer-sponsored coverage.
Under current law, insurance companies can charge older adults up to three times as much as younger people based on their age. This is known as 3-to-1 "rate banding."
The House bill increases the ratio up to five times starting in 2018, unless states set a different age ratio.
Before the Affordable Care Act, premiums for older adults were typically four or five times the premiums charged to younger adults, according to the Kaiser Family Foundation.
That more accurately reflects the actual higher costs spent for older adults’ health care, said Linda Blumberg, health policy expert at the Urban Institute.
So the lower 3-to-1 age ratio in the ACA was a better deal for older adults. The goal was to make coverage more affordable for older adults regardless of their health status.
If the House bill with the 5-to-1 rate banding were to become law, older adults would pay more than current law, according to an estimate by the Rand Corporation, which evaluated an earlier version of the American Health Care Act, or AHCA. (The research was funded by the Commonwealth Fund, which aims to increase health care access for the poor.)
The increased costs would occur, Rand Corporation said, as a result of tax credits in the House bill not increasing with age as steeply as premiums.
Young people, however, would get a break on premiums.
Older Americans could get hit with other costs, too
The change in age ratios is just one of many provisions of the House proposal that could change the costs for older adults.
The legislation would replace the current income-based tax credits with a credit based on age.
For adults over 60, that would mean a $4,000 credit.
For adults under 30, the credit would be $2,000.
The legislation phases out tax credits for individuals who make more than $75,000 annually (or a couple who files jointly earning $150,000).
Kaiser created an interactive map to show that the cost impact varies based on several factors.
"Generally, people who are older, lower-income or live in high-premium areas (like Alaska and Arizona) receive less financial assistance under the AHCA," Kaiser concluded about the House bill.
A Congressional Budget Office analysis of an earlier version of the legislation (the final legislation did not receive a CBO score) concluded that it would disproportionately increase the number of uninsured ages 50-64 with incomes less than 200 percent of the poverty limit.
For an example: Under current law, a 64-year-old with an income of $26,500 would pay a net premium of $1,700 after factoring in a tax credit. Under the House bill, according to CBO, that person’s premium rises to $14,600. (See table 4)
Older Americans could see more changes if states choose to redefine essential health benefits for coverage in the individual market.
"I cannot imagine a scenario where the AHCA is not worse for older adults than the ACA," Blumberg said.
Curbelo’s spokeswoman told us Curbelo has called for improving the bill that he voted for.
"The congressman is continuing to work to ensure that all Americans have access to coverage options they can afford, focusing specifically on making sure we increase the amount of the tax credits for lower income Americans and for those nearing the age of retirement," Joanna Rodriguez told PolitiFact.
The Save My Care ad says that Curbelo voted for a health care bill that will let insurance companies "charge five times more for people over 50."
The ad refers to a provision that will allow insurance companies to charge adults five times more for insurance than younger people buying on the individual market. But the ad could leave a misleading impression that it’s five times more than the current situation -- and that’s not the case. Under the Affordable Care Act, insurers were allowed to charge this age group three times as much for insurance (which was considered a better deal than the situation before). Also, the increase in the ratio applies to Americans ages 50-64 -- not seniors who are on Medicare.
We rate this claim Half True.
Congress.gov, HR 1628, Passed May 4, 2017
AARP, Proposed Health Care Law Hammers People Over 50, March 15, 2017
AARP, Age Tax a One-Two Punch for Older Americans, March 20, 2017
AARP, Letter to U.S. Representative, May 3, 2017
Center for American Progress, The Impact of the House ACA Repeal Bill on Enrollees’ Costs, March 16, 2017
Center on Budget and Policy Priorities, House GOP Health Plan Eliminates Two Medicare Taxes, Giving Very Large Tax Cuts to the Wealthy, March 20, 2017
U.S. Rep. Carlos Curbelo, Curbelo Comments on Healthcare Vote, May 4, 2017
Kaiser Family Foundation, Compare Proposals to Replace The Affordable Care Act, accessed April 27, 2017
Kaiser, What Are the Implications for Medicare of the American Health Care Act? March 14, 2017
Kaiser, How Affordable Care Act Repeal and Replace Plans Might Shift Health Insurance Tax Credits, March 10, 2017
Miami Herald’s Naked Politics blog, "Curbelo, Diaz-Balart vote for Obamacare replacement," May 4, 2017
Society of Actuaries, Health Care Costs—From Birth to Death, June 2013
New Venture Fund, Website, Accessed May 9, 2017
Manhattan Institute, Testimony before Congress by Avik Roy, May 11, 2016
Congressional Budget Office, Private Health Insurance Premiums and Federal Policy, February 2016
CNN, "Push to pin health care vote on vulnerable Republicans begins," May 8, 2017
New York Times, "Repeal of Health Law Faces a New Hurdle: Older Americans," March 5, 2017
Interview, Linda Blumberg, senior fellow in the Health Policy Center at the Urban Institute, May 9, 2017
Interview, Zach Hunter, Communications Director Committee on Energy and Commerce, May 9, 2017
Interview, Christine Eibner, Paul O’Neill-Alcoa Chair in Policy Analysis RAND Corporation, May 9, 2017
Interview, Ashley Balcerza, Center for Responsive Politics blog author, May 9, 2017
Interview, Kasey Hampton, Save My Care spokeswoman, May 9, 2017
Interview, Sara Collins,Vice President, Health Care Coverage & Access The Commonwealth Fund, May 9, 2017
Interview, Dale H. Yamamoto, Red Quill Consulting and author of Health Care Costs—From Birth to Death, May 9, 2017
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