The Winners And Losers In The Republican Health Care Plan


Medical and consumer groups alike are warning that millions of people could lose their health care if Republicans make good on their promise to scrap the Affordable Care Act. But as their legislation makes its way through Congress, President Trump is saying pay no attention to the critics. Trump tweeted this afternoon that the end result will be, quote, “a beautiful picture.” NPR’s Scott Horsley reports what that picture looks like depends on where you’re standing.

SCOTT HORSLEY, BYLINE: Every insurance system relies on a basic bargain. People pay in during good times so they can draw out when times are tough. With health insurance, people in good health subsidize those who are less so. And since none of us knows when we might get sick, we play along.

Obamacare adds two more subsidies to that basic formula. Young people are asked to pay more for insurance so older people can pay less, and the wealthy pay additional taxes to help cover costs for the poor. By undoing those subsidies, the Republican replacement plan would shift costs from young to old and rich to poor. The forecasting firm SP Global estimates on balance, 6 to 10 million people might lose insurance coverage. But SP director Deep Banerjee says more young people would likely sign up.

DEEP BANERJEE: We expect gains from individuals in the age group of 21 to 35 but losses from individuals in the age group of 45 to 64.

HORSLEY: That’s because the Republican plan allows insurance companies to offer stripped-down policies that would be cheaper and more attractive for young people even as the price of policies for older customers goes up.

A typical 21-year-old, for example, might be able to find coverage for around $2,600 dollars a year, most of which could be paid for with a $2,000 tax credit from the government. But a 64-year-old trying to buy insurance might have to pay five times as much, and the maximum tax credit in the GOP

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