More than 1.2 million Texans are signed up for health insurance through the federal marketplace. That’s the part of Obamacare that allows companies to sell plans directly to individuals. Under the GOP replacement bill working its way through Congress, there could be big changes to how the government helps these individuals pay for their plans.
Central Texas, overall, would fare better than other parts of the country. Health care and insurance costs are lower in this part of the state. But there are still some folks here who would be negatively affected by the Republicans' plan.
One of those Texans is Victoria Tisor. She lives in Oak Hill with a vegetable garden in her backyard and three chickens named after the Dixie Chicks.
Tisor is a textbook "responsible adult." Her house is paid off, and she eats healthy, works out and plans everything.
“I am the kind of individual who says, ‘I have responsibility for my own life and my own path,'” she says.
So when the Republican health care plan was first released, she sat down and did the numbers to find out what it might mean for her.
“Well, I’m worried right now,” Tisor says. “I don’t know how it’s going to change in the next few months, but the package that is out there right now is not affordable for me.”
Experts say a lot of folks would find insurance unaffordable under the GOP plan.
“Both premiums and out-of-pocket costs are going to be much higher for some individuals under the bill, specifically people who are low income, people who live in rural areas and people who are older – ages 50 to 64,” says Stacey Pogue with the left-leaning Center for Public Policy Priorities.
Pogue says individuals who fall into two or three of those categories would be hit hardest under the GOP plan.
Tisor falls into two of those categories. She’s 60 years old, and she's on a fixed income, bringing in about $30,000 a year from her pension.
Pogue says a couple of things are working against Tisor. The GOP proposal "raises the underlying cost of the premiums for older enrollees and then it reduces the amount of help – the tax credits they get – to make those premiums affordable,” she says.
This amounts to what Pogue calls an "age tax."
Under Obamacare, people who are older, make less money or live in high-premium areas – which are usually rural areas – get larger tax credits.
But under the Republican plan, that’s almost flipped. If you are younger, make more money or live in low-premium areas – like Central Texas– you will get more help.
Nora Chovanec, 29, also keeps chickens in her backyard, just north of UT. She’s one of almost 114,000 people in Austin who buy insurance through the Obamacare marketplace.
She says right now it’s not possible for her to get covered by an insurer.
“I have a lot of jobs like most people my age," Chovanec says. "I’m a small-business owner -- I started Salud Bitters -- and I also work for Texas Farmers Markets and Travis Audubon and other things on the side.”
Chovanec says she’s used the marketplace for a couple years now. When her business was getting off the ground, she got subsidies from the federal government, but now she’s making more money and pays the full $250 monthly premium herself.
Chovanec says it looks like she could get some help under the Republican proposal.
“I, as a young healthy person, would actually benefit,” she says. “This plan would save me on my taxes at the end of the year.”
Pogue says Chovanec's premium could come down and she could see a tax credit for the first time.
“She would not qualify for a tax credit under the Affordable Care Act because her income is too high," Pogue says, "but she would qualify for a tax credit under the House health plan."
According to an interactive map from the Kaiser Family Foundation, Chovanec is looking at a $2,000 tax credit.
Under the same plan, 60-year-old Tisor would see her tax credit shrink by almost $3,000, and her premiums will go up.
An Uncertain Future
“I understand the high-level math behind that,” Tisor says. “There are more people in my age group that are higher risk. But as an individual I am very, very healthy, I have very low risk activity. Yet, a 28-year-old probably engages in a lot more risky things than me, right?”
This doesn’t sit right with Chovanec, either.
“I am a believer in caring for the other people in your community,” she says. “So, I see how for me it could be a short-term few thousand-dollar benefit, but [it] is really going to have negative effects on a lot of lower-income people and older people.”
“I don’t personally want to be part of a system where I benefit and other people get screwed over,” she says.
Plus, Chovanec says she’s not totally convinced this plan would keep her premiums down in the long run.
Pogue also says out-of-pocket costs like deductibles and copays would go up for everyone under the GOP replacement plan.
Neither Chovanec nor Tisor thinks Obamacare is perfect, either. Both have had their premiums go up since they got in the marketplace.
In fact, Tisor says her plan got so expensive that she decided to take a risk and not have health insurance this year. She says she was planning to get a policy next year, however, but her options aren’t looking good so far.