A Republican plan to overhaul the nation's health care system shows health care could become unaffordable for many poor Oklahomans and the state could be forced to subsidize health care costs for Native Americans, according to an early analysis of the plan prepared for Gov. Mary Fallin.
A document obtained Tuesday by The Associated Press shows state health officials also project the proposed new law would result in the state immediately losing $9.3 million in public health funding for programs such as immunizations and chronic disease funding.
The three-page document prepared last week by state health officials and policy analysts in Fallin's office outlines some of the pros and cons of key provisions in the plan.
Among the top concerns is the proposal to replace income-based subsidies that help people pay for premiums with age-based tax credits.
"This creates a huge subsidy cliff between Medicaid and the individual market that could cause people on Medicaid to not go to work or earn more income because the cost of insurance would be unaffordable," the analysis states. "The subsidy should be based on income and age."
Anna Holloway, a 60-year-old Norman resident who received tax subsidies to purchase health insurance on the federal exchange, said she's fearful the new GOP plan could price her out of the market for health insurance.
"If I didn't have subsidies I couldn't have insurance," said Holloway, who works part-time at a Tulsa seminary and takes medication every day because of an auto-immune disease.
"I am conscious of just how desperate this is," she said, fighting back tears. "I try not to let myself feel this way, but to live this way with real terror, real fear that the universe is going to fall apart around me."
The analysis also suggests there is no indication that the federal government intends to adhere to a previous obligation to pay for tribal members' health care costs, "shifting that burden to the states."
Among the benefits cited in the report is that the age rating change should lower the cost of insurance for young people, who also could be attracted by their ability to buy catastrophic coverage. Oklahoma has one of the highest uninsured rates in the nation, with about 14 percent of residents with no coverage, compared to the national rate of about 9 percent.
Oklahoma also is among the poorer states, with about 16 percent of residents earning below the federal poverty level of $24,250 for a family of four in 2015.
An analysis of the plan by the nonpartisan Congressional Budget Office released this week predicts 14 million Americans would lose coverage next year under the GOP proposal, and that number would balloon to 24 million by 2026.
A separate analysis of the bill by the left-leaning Center for American Progress shows Oklahoma would experience among the highest premium increases by 2020, averaging more than $5,000 per individual. Those annual premium increases are even more dramatic for low-income residents, who would see their premiums increase by about $7,385 by 2020, and Oklahomans aged 55-64, who would see average increases of $12,032.
Fallin said in a statement she's optimistic that Republicans members of Congress are planning to repeal, replace and reform the Affordable Care Act, but described the GOP proposal as a "first step."
"I look forward to seeing what will evolve from this proposal," she said. "I hope the plan will offer strong flexibility to the states to reform Medicaid and the system surrounding it."