In an effort to blunt the American Health Care Act’s disastrous effect on older Americans, House Republican leaders are adding a provision that would set aside $75 billion to do ... something unspecified. 
 
 Really. According to Politico, the new version of the bill will not say at all what to do with the $75 billion. Instead it will just “instruct the Senate” to come up with a plan to use the money to help people between the ages of 50 and 64. 
 
 This is a very unusual way to legislate and reflects House Republicans’ desperation to push through basically anything as soon as possible and pass the buck to the Senate. 
 
 The underlying issue is that the Affordable Care Act provides people earning less than 400 percent of the poverty line with sliding-scale subsidies to purchase health insurance. The less you earn, the more help you get. The ACA also limits insurance companies’ ability to charge older customers higher premiums than they charge to younger ones. 
 
 AHCA changes the subsidies around, ensuring that everyone who makes less than $75,000 a year gets a subsidy that’s based on age. The older you are, the more help you get. This leaves the neediest families out of luck — the subsidy isn’t enough to buy an insurance plan if you’re just barely above the poverty line regardless of your age, so they would end up going uninsured and get nothing from the government at all. 
 
 But even though older people get more generous subsidies, they are worse off than before too. That’s because AHCA allows insurers to charge older people as much as five times what they charge younger ones, so older people’s premiums will skyrocket far beyond anything the subsidy can deliver. 
 
 The result is a health insurance system that really only works for relatively young, relatively affluent people. 
 
 Older people are the Republican base, however, so a bill that badly damages their financial interests is a political problem for many House Republicans. Coming up with an actual fix to this problem is not conceptually impossible. But it would require a pretty substantial rethink of the underlying architecture of the AHCA, which is designed, on a deep level, to better serve the interests of people who don’t need much help while doing less to serve the interests of those who do. 
 
 But Paul Ryan is determined to have the House vote on this bill on Thursday, which means they don’t have time for any big rethink or prolonged negotiation. So what they’ve come up with instead is, apparently, this $75 billion magic asterisk. The House will pass a bill with what amounts to a blank spot, and then members can say they repealed Obamacare and toss the hot potato of working out the details to their colleagues in the Senate. ||||| Republicans’ American Health Care Act would be devastating to older Americans who rely on the individual insurance market, according to an analysis by the Congressional Budget Office. 
 
 The CBO found that the revised Republican bill does bring down overall premiums in the individual market by anywhere from 4 to 20 percent by 2026 compared with what they would be under current law. 
 
 The variation depends on whether a state accepts waivers under the American Health Care Act, which would allow insurers to offer much skimpier health plans at lower premiums. States that take up such waivers would see lower premiums, although the health plans would provide fewer benefits. States that don’t adopt such waivers would have higher premiums, but their health plans would offer more benefits — a trade-off. 
 
 But the CBO’s analysis includes a big caveat: Premiums would differ greatly based on age and income. In general, the older and poorer you are, the higher your premiums would be under the American Health Care Act compared with current law. 
 
 The CBO offers an example of a single individual with an annual income of $26,500. 
 
 If that person is 21 years old, he could benefit from the Republican health care bill. Under the Affordable Care Act (also known as Obamacare), he would on average pay $1,700 in premiums for insurance. Under the Republican plan, he would pay $1,250 if he’s in a state that accepts regulatory waivers and makes moderate changes to market rules — although, again, this also means his health plan would likely be skimpier. If his state doesn’t take up a waiver, his premium would actually increase by $50 to $1,750. 
 
 But if that person is 64 years old, he would be hurt by the Republican bill. Under Obamacare, he would also pay $1,700 in premiums for insurance. But under the Republican bill, he would pay $16,100 (about 60 percent of his annual income) if he lives in a state that doesn’t accept regulatory waivers, and $13,600 — still more than half his annual income — if he lives in a state that does adopt waivers to make moderate rule changes. That amounts to as much as an 850 percent increase in premiums from Obamacare to the Republican bill. 
 
 A 64-year-old who’s making $68,200 a year could fare a bit better. Under Obamacare, he’s expected to pay $15,300 in premiums for insurance, because his income would be too high to receive the law’s tax credits. Under the Republican bill, the tax credit, which is now based on age instead of income, begins phasing out at $75,000. So his premium would drop to $13,600 — a bit below Obamacare levels — in a state that gets a regulatory waiver but would actually increase to $16,100 in a state that doesn’t get a waiver. 
 
 Here’s how all of that looks in chart form: 
 
 Older people with an annual income of $75,000 or more would get fewer to no subsidies under the Republican bill. So they would likely face higher premiums than they did under Obamacare, much like the lower-income consumer. 
 
 The Republican bill accomplishes all of this in two ways. 
 
 First, it abandons Obamacare’s income-based tax credits (which give more money to people with lower incomes) to instead give anyone with an annual salary below $75,000 a tax credit based on age, with older people getting more money and a phaseout for higher incomes. 
 
 But it also peels back an Obamacare rule that protects older people from higher premiums. Under Obamacare, insurers are generally only allowed to charge an older person about three times what they would charge a younger person — under the theory that older people are often sicker and therefore need to use more insurance. But under the Republican bill, the limit of three times would go up to five times, effectively letting insurers charge older people 66 percent more than they would under Obamacare. 
 
 Republicans argue this is necessary because it would also let insurers charge younger people less, which would encourage younger and generally healthier people to come into the insurance pool — and therefore bring down the overall cost of health care by making it so more younger, healthier people are effectively subsidizing everyone’s care. 
 
 The CBO found that’s broadly true: It would bring insurance premiums down in general, and it would cost at least some young people less to get signed up for a health plan. But it would do all of that at a very high cost to older, particularly poorer Americans. ||||| Older Americans are more likely to need more healthcare than their younger counterparts just by dint of their age. Poor, older Americans need that care to be affordable. 
 
 The two bills floated in the Republican-controlled House to replace the ACA also known as Obamacare seem to be putting this demographic in jeopardy as far as gaining affordable, health insurance is concerned. 
 
 The nonpartisan Congressional Budget Office is expected to release its scoring on the Obamacare replace effort Monday, but the AARP has already weighed in with the above conclusion. [Update: Late Monday, CBO scored the Obamacare replace effort and it didn’t looking pretty with 24 million forecast to lose coverage in a decade.] 
 
 In a report published Friday, the lobby group said: 
 
 “The tax credit proposal included in the American Health Care Act (AHCA) of 2017, as introduced on March 6, would provide substantially less assistance for lower- and moderate-income older adults by as much as $5,900 for an individual.” 
 
 And how many such older Americans of limited means are covered by the current healthcare law? More than 3 million, according to AARP. 
 
 The group’s Public Policy Institute crunched some numbers to come up with these data points, per the report: 
 
 50- to 64-year-olds earning $15,000 annually would be eligible for tax credits that are on average 40 to 60 percent less than the amount they would receive under current law. In dollars, their tax credit would be between $2,200 and $5,900 less under the AHCA. 
 
 50- to 64-year-olds earning $25,000 annually would be eligible for tax credits that are on average 50 to 80 percent less than the amount they would receive under current law. In dollars, their tax credits would be between $850 and $4,500 less under the legislation. 
 
 50- to 64-year-olds earning $45,000 annually would see mixed impact. For example, 50-year-olds and 55-year-olds would be eligible for a larger tax credit. Sixty- and 64-year-olds would be eligible for a smaller tax credit. In dollars, their tax credits would range from $1,800 more to $1,800 less under the legislation. 
 
 AARP’s analysis also calls into doubt the success of flat tax credits based on age that are proposed in the two House bills aimed at replacing Obamacare. 
 
 So, only 50-year-olds earning $45,000 annually appear to be coming out on top using the flat tax credit based on age that’s proposed in the GOP-healthcare bills, including the American Healthcare Act (AHCA). 
 
 The report noted: “Under a flat tax credit proposal such as the AHCA, people would face a much larger reduction in tax credits compared with current law as they grew older, even with the adjustment for age called for in the legislation. This raises significant affordability concerns, particularly because premiums already increase with age in the nongroup market and would increase even more under current proposals.” 
 
 But AARP maybe the least of GOP’s worries. The reaction from moderate Republicans, who worry about the fate of poor, older Americans and conservative Republicans who complain that AHCA is Obamacare Lite shows that the healthcare battle maybe one for the very soul of the party. 
 
 Photo: zakokor, Getty
– The American Health Care Act passed by House Republicans earlier this month will reduce the deficit by $119 billion over the next decade—while leaving 23 million more Americans without insurance than if ObamaCare remains in place, according to the Congressional Budget Office's score of the bill released Wednesday. NPR reports that while premiums could go down for some people under the AHCA, the CBO warns of "extremely high premiums" for people with preexisting conditions. Insurance could also be thousands of dollars more expensive for people who are pregnant or have issues with addiction or mental health. The AHCA would reduce the deficit by cutting Medicaid by $884 billion and subsidies for individual health insurance by $276 billion. Whether or not insurance premiums go up for Americans under the AHCA depends partly on what state they live in. The AHCA allows for states to get waivers that would lower premiums by allowing cheaper plans that don't cover "major medical risks." But it also largely depends on age, as Vox explains. A 64-year-old making $26,500 a year would pay between $13,600 and $16,100 for insurance under the AHCA, depending on if their state gets waivers. That's up from $1,700 under ObamaCare. A 64-year-old making $68,200 would also see their premiums increase if they live in a state that doesn't get the waivers. That's because the AHCA allows insurers to charge older people up to five times as much as younger people. The Washington Post reports the Senate is unlikely to pass the AHCA as it stands and is working on its own bill.