State policy options in the American Health Care Act

On May 4, 2017, the U.S. House of Representatives passed the American Health Care Act (AHCA) by a vote of 217-213. The bill aims to overhaul much of the Affordable Care Act (ACA).

Although the AHCA is sometimes referred to as a bill to “repeal and replace” the ACA, it leaves many of the decisions to alter the 2010 health reform law in the hands of states. Given the considerable flexibility in the AHCA for states, Ohio policymakers will have additional policy options available to them if the current bill is signed into law. This publication highlights some of the areas in which Ohio policymakers will encounter new decision points.

County profiles: Monthly premium changes from ACA to AHCA

Below are estimates of the potential change in the average monthly premium for a silver-level plan from the ACA to the AHCA in various Ohio counties, along with a profile of that county’s marketplace enrollees by age and income.

Athens County

Cuyahoga County

Franklin County

Hamilton County

Jackson County

Lucas County

Mahoning County

Montgomery County

Muskingum County

Stark County

Summit County

Washington County

ACA premiums were calculated using data about plans offered on Ohio’s ACA marketplace for plan year 2017 and the ACA’s 3:1 age rating curve and income-based tax credit formula. AHCA premiums were calculated using the same data and the AHCA’s 5:1 age rating curve and age-based tax credit formula that would go into effect beginning in 2020. The estimates do not reflect potential premium changes resulting from waivers, including waivers of EHB and pre-existing condition protections.

Source for premium estimates: HPIO analysis of “2017 QHP Landscape Individual Market Medical” from data.healthcare.gov. Adjustments to premiums prices based on AHCA’s 5:1 age rating curve were made using estimates from a Milliman research report.

Source for Marketplace enrollee information: Centers for Medicare and Medicaid Services