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Individual Insurance Market Could Take A Hit Under GOP Health Plan


Here are two things that forecasters think will happen under a Republican plan to repeal the Affordable Care Act and replace it. Nonpartisan forecasters employed by Congress ran the numbers on this plan. Now, remember, this is a forecast. It's what they think will happen - can never be sure - but the forecast suggests that millions of people will lose or just drop their insurance coverage as prices go up.

At the same time, millions more may be signing up for coverage as cheaper policies become available to them. Those cheaper policies should be more attractive to younger, more healthy people who have not been too drawn to Obamacare. But the stripped-down coverage plans may not do much to help those who need insurance most. NPR's Scott Horsley reports.

SCOTT HORSLEY, BYLINE: If the Congressional Budget Office is right, the GOP plan would bring big changes to the individual insurance market. And some people would welcome that.

CYNTHIA COX: The person who would do best is probably a millennial urbanite who is a bit more affluent or a higher income.

HORSLEY: Cynthia Cox, who studies the individual market at the Kaiser Family Foundation, says health care in big cities tends to be more affordable than in rural areas, where there's less competition. Young people, on average, don't need as much health care. And the GOP plan offers bigger subsidies to people making good money, up to $75,000 a year. On the flip side, those who'd be worse off are people with smaller paychecks and more expensive health care needs.

COX: The person who's likely to have to pay much higher premiums or even go uninsured is someone who's older, lives in a rural area and is lower income.

HORSLEY: Someone like Kathy Miller. She's 61 and self-employed as a therapist in Memphis. Shortly after she got coverage under the Affordable Care Act three years ago, Miller was diagnosed with uterine cancer.

KATHY MILLER: Pretty much, Obamacare has saved my life.

HORSLEY: Miller is feeling better now. And thanks to Obamacare subsidies, she pays just $137 a month for insurance. That subsidy would drop sharply under the Republican plan, and her monthly insurance bills would be a lot higher.

MILLER: If I lose the tax credit because of the Trumpcare plan, then, you know, I would be paying close to $800 a month for health insurance. And I don't know if I could sustain that over an extended period of time.

HORSLEY: Buddy Mondlock's story is similar. He's 57 and makes a modest living in Nashville as a singer-songwriter. Mondlock lived for years with hepatitis C, which he got from a blood transfusion. His Obamacare insurance policy finally paid for the $80,000 treatment.

BUDDY MONDLOCK: About a month in to taking the pills, I was virus-free.

HORSLEY: Like Miller, Mondlock is worried. Under the Republican plan, he'd lose more than $7,000 a year in insurance subsidies, even as his premiums would likely increase.

MONDLOCK: This is not about politics. It's actually a matter of life and death for for many, many people.

HORSLEY: There is some political irony here. The people and places most likely to be hard hit by the change - older, rural, lower income - are the same ones that helped to elect the president. That's why some Republican senators who represent those areas are now talking seriously about possible changes to the GOP bill.

Scott Horsley, NPR News, the White House.

(SOUNDBITE OF SECEDE AND KETTEL'S "DELIRIA NOON") Transcript provided by NPR, Copyright NPR.

Scott Horsley is NPR's Chief Economics Correspondent. He reports on ups and downs in the national economy as well as fault lines between booming and busting communities.