More Older Adults at Risk of Losing Health Insurance with ACA Reforms

Thanks to the Affordable Care Act (ACA), Susana Septimo no longer wages a desperate balancing act between staying healthy or going bankrupt.

Susana, age 62, has diabetes and glaucoma. She is a housekeeper and has no health insurance through her work. Before she purchased a health marketplace through the Affordable Care Act (ACA), she struggled to pay for medications and doctor’s visits.

“It was very difficult,” Susana said. “I really depended on doctors and clinics helping me with free medications and low-cost blood work.”

Even the reduced fees of public clinics were difficult for her to afford. Without insurance, she used to pay $129 for her eye drops to treat her glaucoma and more than $150 for each blood screening. She managed by putting the fees for doctor’s visits and medications on her credit cards and paying the money back over time.

With the premium subsidies and cost-of-share savings (available to low to moderate wage earners through the ACA), she now pays $21 a month premium for a healthcare policy with a low-deductible that covers 94 percent of the cost of her insulin medications. Her medications cost $1.

“Thank goodness this health insurance is available to people like me,” she says. “It saved my life and has allowed me to continue to work.  I now have the security and peace of mind that my health problems can be managed.”

Prior to the ACA, older adults like Susana were most at risk of high premiums or being uninsured, according to a study by the Kaiser Family Foundation:

They were more likely than younger adults to be diagnosed with certain conditions, like cancer and diabetes, for which insurers denied coverage.  They were also more likely to face unaffordable premiums because insurers had broad latitude (in nearly all states) to set high premiums for older and sicker enrollees.

Reforms to the ACA currently being considered could result in a substantial increase in premiums for older adults and loss of share-of-costs savings altogether, which would make health insurance policies unaffordable again, especially for persons of low-to-moderate income.  If the proposed changes under the new American Health Care Act (AHCA) are enacted, over five million older adults are projected to lose health insurance by 2026, according to a recent analysis by the Congressional Budget Office.

Source: Kaiser Foundation. Read more: https://www.kff.org/