It’s unclear exactly how the congressional health-care debate will proceed after Tuesday’s vote, but in an analysis of the most recent Senate health bill, older Arizonans buying individual plans do not fare well.
The Kaiser Family Foundation’s analysis of the Better Care Reconciliation Act (BCRA) released July 20 by Senate Republicans shows annual premium increases of more than 100 percent for some Arizona marketplace plans, with rates varying by age, income and plan level.
Arizona’s disproportionate share of older, lower-income adults puts it at a bigger disadvantage when it comes to the way the BCRA would affect premiums here.
Also, some parts of Arizona have higher marketplace premiums than other parts of the country. With less financial help under the Senate repeal bill, people living in high-premium, rural parts of the state are likely to experience bigger increases, Kaiser researchers found.
The analysis compares premium estimates in 2020 for the BCRA versus what those premiums would be under the Affordable Care Act (ACA), which is current federal law.
Most Arizonans do not get their health insurance on the marketplace because they are covered by Medicaid, Medicare or an employer plan.
The U.S. Department of Health and Human Services says 196,291 Arizonans purchased health insurance on the federal marketplace during the last open enrollment period, including 29,432 in Pima County.
The marketplace consumers faring worst under the BCRA analysis are older adults with lower incomes. In Pima County, a 60-year-old earning $30,000 a year would pay $4,340 per year in annual premiums for a silver-level plan after tax credits and health savings accounts are factored in. That’s an increase of 75 percent over what that same person would pay in 2020 under the ACA, the analysis says.
The percentage increase is higher for that same Pima County 60-year-old if he or she wants a bronze-level insurance plan. Under that scenario, the annual premium would go up by 195 percent, from $910 per year under the ACA to $2,460 per year if the BCRA were to take effect, the analysis says.
A 40-year-old in Pima County earning $30,000 per year would pay slightly more under the BCRA — 9 percent more for a silver plan and 21 percent more for a bronze plan.
Younger people would fare better nationwide under the BCRA and would typically see lower premiums.
In Pima County, a 27-year-old earning $30,000 per year would save 34 percent under the BCRA on a silver-level plan. At higher income levels, the savings get greater.
A 27-year-old in Pima County earning $40,000 per year would save 42 percent over ACA premiums, the analysis says. By comparison, a 60-year-old Pima County resident earning $40,000 per year would see annual premiums go up by 63 percent under the BCRA.
The higher premiums for older adults may face an uphill battle, however.
On Tuesday, the Senate parliamentarian ruled that the provision allowing insurers to charge up to five times more than what they charge younger individuals would require 60 votes rather than a simple majority.