These maps compare county-level estimates of premium tax credits consumers would receive under the Affordable Care Act (ACA) in 2020 with what they’d receive under the American Health Care Act as unveiled March 6 by Republican leaders in Congress.
The maps include premium tax credit estimates by county for current ACA marketplace enrollees at age 27, 40, or 60 with an annual income of $20,000, $30,000, $40,000, $50,000, $75,000, or $100,000. A downloadable spreadsheet of this data is available, as is a spreadsheet with family scenarios, including a family of four with two 40-year old adults and two children, as well as a 60-year-old couple with no dependent children. (Note: the map and spreadsheets do not include cost-sharing assistance under the ACA that lowers deductibles and copayments for low-income marketplace enrollees. For example, in 2016, people making between 100 – 150% of poverty enrolled in a silver plan on healthcare.gov received cost-sharing assistance worth $1,440; those with incomes between 150 – 200% of poverty received $1,068 on average; and those with incomes between 200 – 250% of poverty received $144 on average).
Generally, people who are older, lower-income, or live in high-premium areas (like Alaska and Arizona) receive larger tax credits under the ACA than they would under the American Health Care Act replacement.
Conversely, some people who are younger, higher-income, or live in low-premium areas (like Massachusetts, New Hampshire, and Washington) may receive larger assistance under the replacement plan.
Most current Healthcare.gov enrollees have lower incomes:
- About 66% of have incomes at or below 250% of poverty (approximately $31,250 for a single individual in 2020), with the bulk (44% of all enrollees) having incomes at or below 150% of poverty (approximately $18,750 in 2020).
- About 36% of enrollees are under age 35, 37% are age 35 to 54, and 27% are 55 or older.
Both the ACA and the American Health Care Act include tax credits in their approach. However, the law and the proposal calculate credit amounts differently: the ACA takes family income, local cost of insurance, and age into account, while the replacement proposal bases tax credits only on age, with a phase out for individuals with incomes above $75,000.