The GOP Health Care Bill And New York's Essential Plan

May 12, 2017

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With the House of Representatives passing a bill to replace the Affordable Care Act, New York’s “Essential Plan” may be at risk. Bill Hammond, Health Policy Director at the think tank the Empire Center, joined WSKG's Bret Jaspers to explain.

Interview highlights:

On what the Essential Plan actually is:

Bill Hammond: It's a very low-cost health plan. Totally funded by the government. It was an optional benefit under the Affordable Care Act, Obamacare ... More than 600,000 people have enrolled. It's for people who are below two times the federal poverty level and it costs no more than $20 a month.

On how the American Health Care Act (AHCA), the GOP bill that passed the House, would affect the Essential Plan:

BH: It doesn't technically eliminate the authority to have an Essential Plan. But it cuts some of the funding that was being made available for a state that wanted to do [the essential plan]. And without that funding, [the program] would become increasingly unaffordable for New York State.

On what would happen to people enrolled in the Essential Plan if it were to lose funding and no longer be offered:

BH: About a third of them would be eligible to be on Medicaid and they would be transferred back to Medicaid. So their coverage would be disrupted but they would still have coverage. And Medicaid is free so they would not be in any kind of difficulty. 

But there's another 400,000 people or so. They would be in the position of trying to buy private coverage through the exchange and they would be doing so with these different kinds of subsidies. The old tax credits used to be based on income. So if you were low income you got very generous tax credits that made the premiums more affordable. The new tax credits are based on age ... And so it's possible that some of these people - because they're very low income - they were getting much higher tax credits under Obamacare than they would under the Republican alternative. And they might not be able to afford insurance.