Age based subsidy impacts in North Carolina

One of the possible plans for healthcare that is circulating in Washington is the House bill that leaked to Politico.  Its coverage concept is to give all people who are uninsured an age based refundable tax credit.  This will benefit, all else being equal, individuals who are currently not subsidized because they earn too much money for the ACA subsidies.  It will have significant negative effect for lower income North Carolinians because it is a major change from income based subsidies to age based subsidies.  North Carolina has a fairly expensive insurance market which the current subsidies hide from people who make less than 400% of the federal poverty level (FPL).

The following map consists of the least expensive 2017 qualified health plan in each county for a single forty year old non-smoker with the flat age based subsidy applied.  This is what an individual would need to pay every month for a policy that has at least a $6,325 deductible or in more common benefit designs, an out of pocket maximum of $7,000 or more.

North Carolina 40 year old QHP.png

Other factors could apply that will change these numbers such as less expansive Essential Health Benefits that would decrease these numbers. But the costs outlined in the map above are a rough estimate of the state level impact of age based subsidies.

About David Anderson
I am a research associate at the Margolis Center for Health Policy. I've written about health policy at as Richard Mayhew where I've enjoyed explaining the logic behind why an insurance company is behaving the way it is as there is almost always a reason besides pure spite or evil.

One Response to Age based subsidy impacts in North Carolina

  1. Steve Bowden says:

    From what I’ve read, I get the impression that the plan you reference does not have a lot of a chance at being passed because it will not be supported by several Senators or the House Freedom Caucus. If that plan ultimately does not wind up replacing the ACA, what do you think the chances are that any final ACA replacement will contain age-based subsidies instead of income-based subsidies?

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