■ Obamacare’s “age rating” rule lowers premiums for older Americans, who tend to use more health care services — though it raises prices for younger customers.
By discouraging older people from buying insurance, the plan would lower the average sticker price of care. But that doesn’t mean prices would get lower for everyone.
■ States that pursue waivers of these three rules would be required to set up special programs for high-cost patients. States have tried high-risk pools before, with mixed results.
Many states had to turn applicants away — in some states, only a small percentage of those who applied received coverage — and the insurance was sharply limited to control spending.
All of these changes would be added to the basic structure of the American Health Care Act, which reshapes the health insurance system.
■ The bill would change the federal-state Medicaid program for all its 74 million beneficiaries, not just those who joined because of Obamacare.
“This is potentially more major than repealing the Affordable Care Act,” said Joan Alker, the executive director of the Center for Children and Families at Georgetown University.
■ It would rearrange the subsidy system that helps middle-income Americans buy their own insurance coverage, creating new winners and losers.
The winners are likely to be younger, earn higher incomes and live in areas where the cost of health insurance is low.
We don’t have an estimate of effects of the bill with the new changes, but we have some sense of the original bill’s impact.
■ The Congressional Budget Office says an older version of the bill would mean that 24 million more Americans would lack health insurance in a decade.
The Republican bill would actually result in more people being uninsured than if Obamacare were simply repealed.
■ In addition to the insurance changes, the bill would also make big tax cuts, particularly on income from investments. Taken together, the bill would redistribute resources from the poor to the rich.
It would offer new financial benefits for the upper-middle class and the rich.
Those shifts can be summarized in a simple chart.
An average family making more than $200,000 a year would gain $5,640 while a family making less than $10,000 a year would lose $1,420.
The articles summarized above come from me, Reed Abelson, Haeyoun Park and Kevin Quealy.