Analysis says Trump voters would be among biggest losers in Republican health care plan,
WASHINGTON — Americans who swept President Donald Trump to victory — lowerincome, older voters in conservative, rural parts of the country — stand to lose the most in federal health care aid under a Republican plan to repeal and replace the Affordable Care Act, according to a Los Angeles Times analysis of county voting and tax credit data.
Among those hit the hardest under the House bill are 60-year-olds with annual incomes of $30,000. In nearly 1,500 counties nationwide, such a person stands to lose more than $6,000 a year in federal insurance subsidies. Ninety percent of those counties backed Trump, the analysis shows.
And 68 of the 70 counties where these consumers would suffer the largest losses supported Trump in November.
Most affected by the Republican health care plan would be parts of Alaska, Arizona, Nebraska, Tennessee and Oklahoma, where insurance subsidies have been crucial in making highprice insurance affordable. All five states went for Trump. Also hit hard would be parts of swing states that backed Trump, including Pennsylvania, North Carolina and Michigan.
Older, low-income residents of some parts of California, including rural counties in the northern part of the state, could also see substantial losses, the data show.
Meanwhile, higherincome, younger Americans — many of whom live in urban areas won by Democrat Hillary Clinton — stand to get more assistance in the Republican legislation.
Faring best would be the nation’s wealthiest residents, who would get a substantial tax cut with the elimination under the House bill of two levies on high-income taxpayers. Those taxes — on individuals making more than $200,000 and couples making more than $250,000 — were included in the Affordable Care Act to help offset the cost of assisting lower-income Americans.
Only a small share of
the electorate receives Affordable Care Act subsidies, but the loss of the aid could deprive tens of millions of a critical lifeline.
The Times analysis is based on county election results compiled by the Associated Press and a report by the nonprofit Kaiser Family Foundation of the projected value of insurance subsidies in 2020 under current law and under House Republicans’ proposed alternative.
The potential effect of the House legislation is making many Republican lawmakers uncomfortable, including senators from states such as Ohio, West Virginia, Alaska and Arkansas, which have large numbers of lowincome white voters who have benefited from the Affordable Care Act.
The president last week pledged an Affordable Care Act that would “lower costs, expand choices, increase competition and ensure health care access for all Americans.”
The House Republican plan would benefit older, lower-income people who now get relatively small subsidies and live in a few parts of the country including Boston and New York City.
That 60-year-old Boston shopper who would qualify for a $3,450 subsidy in 2020 under the current law would get an increase to $4,000 under the House plan, according to Kaiser’s analysis.
The Republican legislation also would help middle-income Americans who make more than $48,000 a year. Those people currently don’t qualify for assistance. But under the GOP plan, consumers with incomes as high as $114,000 could get subsidies.
John McDonough, a former Democratic Senate staffer, said the proposed system misses the fundamental point of targeting assistance at the neediest consumers.
“The problem facing Americans who have limited financial resources is they simply can’t afford health insurance,” he said.
In western North Carolina, which helped power Trump’s victory, subsidies would fall by more than $10,000.
Trump and other Republicans say that those voters will nevertheless reap the benefits of the GOP alternative.