In their campaigns, Republican candidates for Congress and the presidency were unanimous in denunciations of the Affordable Care Act (ACA) for increasing health insurance premiums and deductibles. Senate Republicans are struggling to pass a plan called the “Better Care Reconciliation Act” (BCRA) that would increase premiums and deductibles even higher than those currently paid under the ACA.

Gary Claxton, Anthony Damico, Larry Levitt, and Cynthia Cox of the Kaiser Family Foundation have estimated the increases in premiums for plans matching the extent of coverage currently available under ‘silver’ plans for the year 2020. To focus on the impact on family budgets, they report premium amounts after the tax credits that subsidize purchases of health insurance are accounted for. Kaiser researchers found that marketplace enrollees would pay on average 74 percent more toward the premium for a benchmark silver plan in 2020 under the BCRA than under current law.

Economic Snapshot Which states are harmed the most under the Senate TrumpCare plan? : Average premium cost increases by state, 2020 State Percentage ObamaCare BCRA Alabama 164% $156 $411 Alaska 142% $332 $804 Oklahoma 140% $199 $477 South Dakota 111% $238 $501 North Carolina 109% $187 $391 West Virginia 108% $282 $585 Louisiana 105% $179 $368 California 103% $190 $386 Nebraska 99% $223 $442 Hawaii 89% $208 $394 Montana 89% $269 $507 Tennessee 86% $233 $434 Wyoming 84% $197 $363 Kansas 82% $208 $379 Mississippi 79% $120 $215 Texas 78% $182 $325 Wisconsin 78% $234 $418 Missouri 77% $175 $308 North Dakota 76% $217 $381 Connecticut 75% $280 $488 Iowa 75% $224 $391 Maryland 74% $191 $333 Nevada 73% $168 $292 Pennsylvania 72% $234 $403 Georgia 71% $170 $291 Idaho 71% $171 $291 Florida 69% $140 $237 Michigan 69% $165 $279 Utah 67% $144 $241 South Carolina 66% $157 $262 Virginia 66% $182 $302 Colorado 65% $333 $552 Minnesota 65% $389 $640 Arkansas 60% $188 $299 Delaware 60% $241 $385 Rhode Island 60% $162 $259 New Mexico 59% $248 $395 Illinois 57% $248 $390 Oregon 54% $257 $395 Arizona 53% $328 $503 Ohio 52% $223 $338 Kentucky 49% $236 $352 New Jersey 49% $223 $333 Indiana 48% $207 $307 Maine 48% $203 $301 New Hampshire 43% $242 $347 Washington 33% $213 $282 Washington D.C. 22% $409 $497 Vermont 21% $292 $354 Massachusetts 14% $149 $169 New York 12% $358 $400 Data are for average premiums that current marketplace enrollees would pay, after receiving any premium tax credit, for a benchmark silver plan in 2020 under current law and under the BCRA Gary Claxton, Cynthia Cox, Anthony Damico, and Larry Levitt, Premiums under the Senate Better Care Reconciliation Act, Kaiser Family Foundation, 2017. Share on Facebook Tweet this chart Embed Copy the code below to embed this chart on your website. Download image

In Alabama, for example, premiums would increase 164 percent from $156 a month to $411 under the BRCA. In Alaska, they would increase 142 percent from $334 a month to $802 a month. The reductions in premium subsidies, in concert with tax cuts for the wealthy, will cost Americans jobs as well. Because low- and moderate-income households tend to spend a much higher share of their disposable income, the overall effect of the BCRA would be less spending and lower aggregate demand across every state and congressional district.

This pain is highly unequal in its distribution, in more ways than one: There are differences in net premium increases among the states. These results actually understate the increases in out-of-pocket costs under BCRA since they do not reflect the higher deductibles that would be imposed.