Nebraska Deductibles Skyrocket under the Senate Bill to “Repeal and Replace” the Affordable Care Act
Opponents of the Affordable Care Act (ACA) complain about high deductibles, but the Senate health care repeal bill would dramatically increase deductibles, rather than lower them.
In Nebraska, 52,018 consumers in the state’s marketplace—nearly two out of every three marketplace enrollees (65%)–would see their per person deductibles rise from an average of $1,325 to $6,000—a 353% increase. Very few people in the marketplace would be charged lower deductibles.1
How the Senate health care repeal bill raises deductibles
- It cuts premium tax credits. Smaller credits would buy less generous plans that have higher deductibles. Average deductibles for insurance funded by these shrunken tax credits would rise from the current $3,600 to $6,000.2
- It completely eliminates the ACA’s payments that help low-wage, working families afford better coverage. The bill ends these payments—known as cost-sharing reductions (CSRs)—starting in 2020. Today, CSRs lower average deductibles from $3,600 to either $2,900, $800, or $300, depending on household income.
Deductibles are what people must pay for health care before their insurance kicks in. Raising them dramatically would impose financial burdens and make it harder for Nebraskans to get the medical care they need. The Senate health care repeal bill takes Nebraska in exactly the wrong direction.
How the Senate health care repeal bill’s $6,000 per person deductible would affect Nebraskans at different income levels
Out of approximately 80,000 people (80,213) covered through Nebraska’s Marketplace:3
- 22,445 Nebraskans now have average per person deductibles of $300. Their deductibles would rise by $5,700, a 1,900% increase.4 These are people with incomes between $13,670 and $20,505 for a single individual or between $27,950 and $41,925 for a family of four.5 For family coverage, deductibles are typically twice the per person amount.
- 13,818 Nebraskans now have average per person deductibles of $800. Their deductibles would rise by $5,200, a 650% increase. These are people with incomes between $20,505 and $27,340 for a single individual or between $41,925 and $55,900 for a family of four.
- 7,962 Nebraskans now have average per person deductibles of $2,900. Their deductibles would rise by $3,100, a 107% increase. These are people with incomes between $27,340 and $34,175 for a single individual or between $55,900 and $69,875 for a family of four.
- 7,793 Nebraskans now have coverage with average per person deductibles of $3,600. Their deductibles would rise by $2,400, a 67% increase.6 These are people with incomes between $34,175 and $54,680 for a single individual or between $69,875 and $111,800 for a family of four.
The overall impact of the Senate’s health care repeal bill’s $6,000 deductibles on working Nebraskans
Altogether, 52,018 Nebraskans—most Nebraskans on the marketplace—would be directly affected by the Senate health care repeal bill’s dramatic increase to deductibles for marketplace coverage. Their current average deductible is $1,325.7 The Senate health care repeal bill would raise that amount by nearly $4,700—a 353% increase, on average.
If anything, this analysis understates the impact of the Senate bill, because it uses the $6,000 average deductible for 2017 bronze coverage to show what consumers would receive under the Senate legislation. In fact, the Senate health care repeal bill pegs premium tax credits to coverage less generous than any bronze plans sold in 2017. Based on the federal tool used to measure generosity of 2018 plans, deductibles for these plans are likely to be around $7,350.8
Consumers have other health care costs, in addition to deductibles. Marketplace consumers must pay premiums to enroll; and even after enrollees pay their premiums and deductibles, insurance companies typically charge copayments or other cost-sharing.9 The Senate health care repeal bill would add much higher deductibles to these already significant expenses of marketplace coverage.
For low-wage, working families and middle-income Americans, higher deductibles both increase financial burdens and raise barriers to getting needed medical care. Faced with higher deductibles, many people delay seeking health care until their medical problems worsen into emergencies. Others stop buying coverage, because it no longer seems worth the cost in premiums. Either way, consumers suffer.
The Senate health care repeal bill’s increase to deductibles is just one in a series of blows the legislation would strike against state residents.10 Put simply, the legislation would mean higher costs, lower-quality insurance, and less access to care for thousands of Nebraskans who rely on marketplace coverage.
View full background and methodology for this analysis.