In response to Tuesday’s Senate vote on the motion to proceed to consider a health care bill that would cut Medicare and Medicaid and impose an Age Tax on older Americans, AARP Executive Vice President Nancy LeaMond released the following statement:
“AARP is disheartened that a majority of Senators voted to move forward on a bill that would devastate millions of Americans. Today’s vote means the Senate is one step closer to passing legislation that will price gouge people over age 50 and strip health insurance from tens of millions of Americans.
“AARP will continue fighting to stop the Senate from passing any bill that increases costs, imposes an Age Tax, strips coverage from people, cuts Medicare, and cuts the Medicaid services seniors need to stay in their homes.
“Any Senator considering voting for the health care bill should understand the consequences of ignoring AARP’s 38 million members. People over age 50 overwhelmingly vote and they will remember who voted to give them a $13,000 premium hike. AARP will print every Senator’s vote in AARP Bulletin, a publication read by 30.4 million people.
“None of the current bills is the right way to fix health care. AARP stands ready to work with Congress on bipartisan solutions that will lower costs and improve care.”
To learn more, visit www.aarp.org or follow @AARP and @AARPadvocates on social media.
The just-released Senate bill, Better Care Reconciliation Act (BCRA), is very bad news for older adults. The bill reduces financial assistance (premium tax credits and cost-sharing subsidies) and changes rules on how much premiums can vary by age (age-rating). As a result, people ages 50 to 64 would have to pay thousands of dollars more in premiums to buy health insurance in the individual (non-group) market.
Here are four ways the bill would increase the cost of health insurance for older adults ages 50-64:
#1: Older adults would pay five times more than other adults.
The bill would allow insurers to charge people 50 and older up to five times more than younger adults (as opposed to up to three times more under current law) – known as 5:1 age-rating. We estimate that this change alone would increase older adults’ premiums by over $4,000 a year on average across all states.¹
But the bill does even more to make coverage unaffordable.
#2: Many older adults would no longer qualify for premium assistance and would have to pay significantly more.
Starting in 2020, the bill would eliminate premium tax credits for people who earn between 350 percent and 400 percent of the federal poverty level (FPL), which corresponds to incomes between $42,210 and $48,420 in 2017.
When the bill is in effect, a 60-year-old earning $45,000 would have to pay $11,800 more a year in premiums than they would under current law just to keep the same level of coverage he or she has today (Table 1). Their premium under BCRA would be $16,133 a year – over a third of their annual income and more than three and a half times what they would pay under current law. The impact of this change would be even worse in some states, especially in rural areas and parts of the country where health care costs are high (see Table 2 for premium increases in all states). In West Virginia, for instance, that same 60-year-old would end up paying $22,530 a year, which is nearly $18,200 more than what they would pay under current law. In Alaska, a 60-year-old who loses eligibility for this assistance would pay $37,700 a year for the same coverage – a whopping $31,600 more a year than under current law.
#3: Older adults eligible for premium assistance would receive much less financial help.
The BCRA significantly reduces premium tax credits for people that still qualify for financial assistance; consequently, millions of older adults would pay a lot more under the bill. Current law protects people with lower and moderate incomes by capping their premium payments. The Senate bill would increase the cap for older people and require them to contribute more of their income. In addition, under current law, the amount by which a person’s premiums are reduced (the tax credit) is based on the price of a silver plan. Under the Senate bill, tax credits would be based on the price of a bronze plan. Don’t be fooled by the technical nature of this change – it has huge implications. Since bronze plans costs less (because they cover less) than silver plans, this means that tax credits under the BCRA would be far smaller than under current law.
As a result, even those qualifying for tax credits would face higher premiums. A 60-year-old earning $40,000 would have to pay $4,500 more in 2020, –an increase from $4,000 under current law to over $8,500–, just to keep the same level of coverage.
#4: Older adults with lower incomes would no longer receive critical cost-sharing reductions to afford their care.
And finally, the bill eliminates subsidies that nearly 70 percent of 50-to-64-year-olds with premium tax credits receive. These subsidies, known as federal cost-sharing reductions, are available to people with incomes at or below $31,250 a year. They help them pay for out-of-pocket costs like deductibles, coinsurance, and co-pays. Eliminating these cost-sharing reductions means that a person earning $20,000 a year could face up to $4,500 more in out-of-pocket bills. This increase would be in addition to the increase in premiums they would face!
Here is the bottom line: Under the Senate’s Better Care Reconciliation Act, all older adults would face significantly higher costs for individual coverage.
Lina Walker is vice president at the AARP Public Policy Institute, working on health care issues.
Claire Noel-Miller is a senior strategic policy adviser for the AARP Public Policy Institute, where she provides expertise in quantitative research methods applied to a variety of health policy issues related to older adults.
Jane Sung is a senior strategic policy adviser with AARP’s Public Policy Institute, where she focuses on health insurance coverage among adults age 50 and older, private health insurance market reforms, retiree coverage, Medicare supplemental insurance and Medicare Advantage.
Olivia Dean is a policy analyst with the AARP Public Policy Institute. Her work focuses on a wide variety of health-related issues, with an emphasis on public health, health disparities, and healthy behavior.
¹Calculations by AARP Public Policy Institute, based on premium data from the Kaiser Family Foundation. Estimated premium increases are for 2020 if people keep their current silver level of coverage.
This week, the U.S. Senate began its consideration of the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act – an important piece of legislation that would start a national conversation about ways to aid American’s greatest support system – family caregivers. Thanks to the leadership and support of Senators Susan Collins (R-ME), Tammy Baldwin (D-WI), Lisa Murkowski (R-AK), and Michael Bennet (D-CO) and Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) the bill was quickly approved by the Senate Health, Education, Labor and Pension Committee (which goes by the very appropriate acronym . . .HELP).
Every day, more than 40 million Americans across the country are caring for parents, spouses, children and adults with disabilities and other loved ones so they can live independently in their homes and communities for as long as possible. They manage medications, help a loved one with bathing and dressing, prepare and feed meals, arrange transportation to medical appointments (or do the driving themselves), handle financial and legal matters and much, much more. Many do all of this while working full-time and raising families.
The unpaid care family caregivers provide — a staggering 37 billion hours valued at about $470 billion annually — helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.
I know from firsthand experience that caring for a loved one is a tremendous responsibility. As my two millennial sons and I care for my husband, their father, who has ALS, I know that, while my experience may be in some ways unique, I have much in common with my fellow caregivers. Every family caregiver I encounter – including the thousands who have shared their stories on AARP’s I Heart Caregivers – expresses a need for support, whether that means help at home, training, workplace flexibility, or the opportunity to get some relief from their caregiving responsibilities.
The RAISE Act Family Caregivers Act recognizes this tremendous need and calls for the development of a national strategy to support family caregivers, bringing together stakeholders from the private and public sectors to identify specific actions communities, providers, government, employers and others can take to make it easier to coordinate care for a loved one, get information, referrals and resources, and improve respite options so family caregivers can reset and recharge.
AARP commends the sponsors of the RAISE Family Caregivers Act — as well as the co-chairs of the bicameral, bipartisan Assisting Caregivers Today (ACT) Caucus — for their leadership on this important issue. They understand that family caregiving is not a Democratic or a Republican issue, or even an older or younger person’s issue. Recent research shows that a surprising one-quarter of Millennials are family caregivers. And, according to a poll we conducted, four-in-ten Millennials say that they are already worried about taking care of their parents on a day-to-day basis.
In fact, this is a family issue that touches us all. We are either family caregivers now, were in the past, will be in the future — or will need care ourselves one day.
Last year, we made tremendous progress on this important piece of legislation. This year, we look forward to working with the bill’s Senate and House champions – as well as other organizations that advocate for and support family caregivers as well as family caregivers themselves – to push this bill over the finish line.
Nancy LeaMond, chief advocacy and engagement officer and executive vice president of AARP for community, state and national affairs, leads government relations, advocacy and public education for AARP’s social change agenda. LeaMond also has responsibility for AARP’s state operation, which includes offices in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands.
You can follow her on Twitter @NancyLeaMond.
Photos: iStock/BraunS, iStock/ktaylorg, AARP