Jun 28, 2017

How premiums would change under the Senate health bill

The Senate health care bill would raise premiums for older and lower-income Americans on exchanges compared to current law, much like the House bill, according to an analysis by the Kaiser Family Foundation. Some younger people would pay less in premiums, but deductibles would likely rise across the board.

Data: Kaiser Family Foundation; Chart: Chris Canipe and Lazaro Gamio / Axios
Data: Kaiser Family Foundation; Chart: Chris Canipe and Lazaro Gamio / Axios

What the Senate bill does:

  • Changes the benchmark plan — the one that's linked to the subsidies. Under the Affordable Care Act, subsidies are tied to "silver" plans that cover 70 percent of an enrollee's health care costs. Under the Senate bill, they're tied to plans that only cover 58 percent of the costs. This means subsidies will be smaller.
  • Changes the required income percentages enrollees must pay towards their premiums. Younger people would generally have to pay less of their income, but older people would have to pay more.
  • Allows older people to be charged premiums five times higher than younger people, compared to three times higher under current law.
  • Rewrites the eligibility rules. People would be eligible for subsidies if their incomes are below 350 percent of the federal poverty line, rather than between 100 and 400 percent of the federal poverty line under the ACA.

Why this matters: Premiums for silver plans would at worst become unaffordable for some people, while others would see their costs go up. This may make some people switch into bronze plans, but these plans have substantially higher deductibles. The bottom line is most Americans will pay more out of pocket for their health care on the individual market, and that's not politically popular.

Go deeper