What if you earn more money?

Following WASHINGTON — criticism from organizations representing older Americans, House Speaker Paul Ryan, R-Wis., modified a health care bill he backs to help people between ages 55 and 64 buy individual health insurance policies.

In a letter to Congress and a TV commercial, AARP assailed the House Republican leadership health care plan which would replace the 2010 health care act signed by former PresidentBarackObamaandknown as Obamacare.

The TV commercial, called “Stop The Age Tax,” runs an unusually long time of 1 minute and 18 seconds. In it, a man in his 50s chops wood and complains the GOP bill overcharges “older Americans for their health insurance.”

So is AARP, which represents 38 million people, correct? Let’s check.

How does the House Republican leadership bill change the individual market?

Under Obamacare, a family of four earning between $34,000 and $98,000 a year a year can receive subsidies to buy individual polices through the exchanges. The Republicans would scrap the subsidies and substitute a refundable tax credit ranging from $2,000 a year to $4,000 a year based on how old you are as opposed to income. A 27-year-old would be eligible for the $2,000 credit while a 60-year-old would be eligible for the $4,000 credit. When an individual earns more than $75,000 a year, the refundable tax credit is slowly phased out.

What is a refundable tax credit?

Unlike an ordinary tax credit, a refundable tax credit means an individual can receive more federal dollars as a refund than they actually paid in taxes.

How does the Republican refundable tax credit compare to the Obamacare subsidies people receive to buy individual policies in the exchanges?

Depends on your age and where you live. According to the Kaiser Family Foundation, a 27-year-old earning $30,000 a year in Montgomery County would receive a $2,000 tax credit under the Republican bill to buy an individual policy compared to $480 subsidy under current law. A 40-year-old would receive a $3,000 refundable tax credit compared to $1,130 under Obamacare. But a 60-year-old earning $30,000 a year would receive the $4,000 refundable tax credit under the GOP bill compared to $5,190 a year under Obamacare.

Kaiser calculates a 27-yearold in Montgomery County earning $50,000 a year would receive a $2,000 a year tax credit under the Republican plan compared to nothing under Obamacare. A 40-yearold would receive a $3,000 tax credit compared to nothing under Obamacare. By contrast, a 60-year-old earning $50,000 annually would receive a $4,000 tax credit under the GOP bill versus a $2,570 subsidy.

What if you live in a different county?

You can use the following link to check for yourself: http://kff.org/interactive/tax-credits-under-the-affordable-care-act-vs-replacement-proposal-interactive-map/

Any other changes that could hurt someone older?

Under Obamacare, insurers cannot charge premiums to older people that are more than three times what they charge younger people. Under the House Republican plan, they can charge five times what they charge younger people.

So it appears if you are older and earn less, you do not do not do as well under the GOP plan as Obamacare?

Probably, but not definitely. Republican sponsors hope by making the refundable tax credit so generous for younger people, it will encourage younger and healthier people to buy policies through the exchanges, resulting in a drop in insurance premiums. The non-partisan Congressional Budget Office last week calculated that under the GOP bill, premiums would decline by 10 percent between 2020 and 2026.

Have Republicans offered any changes to help people in the 60-year-old range?

In his modifications, Ryan has created a pathway for the Senate to possibly increase the amount of the refundable tax credits for people in the 55-to64 age range. But he has opposition from some in his party and no Democrat has come out in support of the bill, so passage is not guaranteed.

How many people does this impact?

Somewhere between 18 and 29 million in the individual market because the overwhelming majority of Americans already have coverage. About 156 million Americans receive health insurance through their employers while 55 million seniors are on Medicare and 74 million low-income earners are on Medicaid.

Just how did the 2010 health law known as Obamacare work?

The uninsured could obtain coverage in two ways. The law expanded Medicaid to allow a family of four earning as much as $33,948 a year to be eligible. But for families of four earning between $34,000 and $98,400 a year, they could receive federal subsidies to buy individual insurance policies through the federal or state marketplaces, known as exchanges. People were fined if they did not buy a policy. But a number of insurance companies dropped out of the exchanges because not enough younger and healthier people signed up for insurance, which led to companies losing money on the exchanges.