According to an analysis by the state budget office, the changes to the affordable care act with the new American Health Care Act would cost the state and extra $126 million dollars per year. (Helena IR Article)
Of course, that would never pass since it would be a 10% increase to the overall state budget. So the more likely conclusion is that the Medicaid expansion that allowed 34,000 more Montanans have insurance will be removed.
What is crazy is Medicaid expansion was only opened up recently (due to GOP pushback at the state level) even though for years there was a 90% federal pick up of the bill. But with the new GOP bill, the federal match will be 65.5% which the state would then have to pick up the 34.5% difference (which is where the 126 million dollars comes from)
So who benefited from the Medicaid expansion, why poor people of course. You had to make no more than 138% of the federal poverty limit
2017 POVERTY GUIDELINES FOR THE 48 CONTIGUOUS STATES AND DC
PERSONS IN FAMILY/HOUSEHOLD POVERTY GUIDELINE
For families/households with more than 8 persons, add $4,180 for each additional person.
So if you are a family of 4 with 2 people making minimum wage working full time your yearly income before taxes would be 33,904 you would just barely qualify for the program.
But let’s say you wanted to get a plan on the exchange because Medicaid expansion is gone
With the ACA
Estimated financial help:$1,149 per month ($13,790 per year)as a premium tax credit. This covers 92% of the monthly costs.
Your cost for a silver plan:$97 per month ($1,163 per year)in premiums (which equals 3.43% of your household income).
Without the ACA
your silver plan would cost:$1,246 per month ($14,953 per year)
But under the GOP plan- you would get a $ 3000 tax credit (maybe 6,000 for 2 adults, not quite sure how that works) to cover the plan that cost $14953 per year which means the family making 33, 904 per year would have to fund out of pocket 11,953 to keep health insurance.
So a family making let’s just say 34,000 year spends 12,000 a year for health insurance, and to make the 34000 would have to have both kids in daycare which can cost on the low end 500 per kid per month, so another 12000 per year.
That leaves them $10,000 to provide housing, in Montana where the average rent is $725 a month, so 8700 a year.
So to cover utilities, transportation, and food this family of 4 has 1300 for the whole year.
What does that mean, well it means you give up health insurance, because you need to work to live, and you need daycare if you have to work, and you need a roof over your head with heat and water, and you need transportation to work. And even that may just add up to barely making it without health insurance. But if the Medicaid expansion were to stay, you could probably muster up the $97 per month for coverage. Though that doesn’t mean you have anything left over for things like deductibles and co-pays.
A study by the Center for American Progress estimated that Montana residents would face the 10th highest cost increases in the nation under the federal legislation, compared to the Affordable Care Act. Particularly hard hit would be people between 55 and 64 years of age, according to the study. Those individuals would pay $8,150 more in costs — a combination of premiums, tax credit adjustments, co-pays and deductibles — than what they pay under the Affordable Care Act, if the legislation took effect this year.
Particularly hard hit would be people between 55 and 64 years of age, according to the study. Those individuals would pay $8,150 more in costs — a combination of premiums, tax credit adjustments, co-pays and deductibles — than what they pay under the Affordable Care Act, if the legislation took effect this year.
It also means for my teacher friends that no retiring early. Even though most of us will have our 30 years of teaching in by the age of 55, we will have to work another 10 years, which will actually make it tougher for school districts because you will have more teachers at the high end of the salaries because we are not retiring because we can’t afford insurance if we retire.