If Thom Tillis made $40k a year, what would he think of the Republican health plan?

The Observer editorial board

Sens. Thom Tillis and Richard Burr - along with other wealthy Americans - would benefit from the BCRA.
Sens. Thom Tillis and Richard Burr - along with other wealthy Americans - would benefit from the BCRA. AP

If you were Thom Tillis, but without his paycheck, would you think the Senate Republican health plan is a good idea?

Let’s say you were 60 years old, just four years older than Tillis, and from Mecklenburg County, as he is. If you made $40,000 and purchased a Bronze plan on the Affordable Care Act exchange, you’d pay about $1,100 in premiums after tax credits. Under the Republican health plan – the Better Care Reconciliation Act – you would pay $5,420, according to a Kaiser Family Foundation analysis. That’s an increase of 393 percent.

What if you were Richard Burr, but without his income? You’ve just passed your 60th birthday, as he has, and you hail from the same Forsyth County. If you made $50,000 and decided on the Bronze ACA plan, you’d pay $2,360 in premiums after tax credits. Under the BRCA, you’d pay $17,210, a 629 percent increase.

If you’re fortunate enough to make $75,000, it doesn’t matter what plan you choose. Your premiums would go up only 34 percent.

But if you are actually Thom Tillis or Richard Burr, then you are worth millions of dollars each and don’t worry about insurance premiums in the same way. You also don’t fret so much about the Congressional Budget Office’s score of the BCRA on Monday, which estimated that 22 million people would lose insurance coverage compared with Obamacare – including 15 million in the first year.

None of those people, of course, would be the wealthy that Thom Tillis or Richard Burr represent. The wealthy not only can afford whatever health plan they choose – they would benefit from the BRCA eliminating taxes the Affordable Care Act levied on high-income Americans.

But if you live in rural part of their state, or any state, you might feel differently. That’s especially true if you’re elderly or potentially a patient at a rural hospital that treats a large share of low-income patients. “Let’s not mince words,” Bruce Siegel, president of a national coalition of about 300 such hospitals, said this week. “This bill will close hospitals. It will hammer rural hospitals, it will close nursing homes. It will lead to disabled children not getting services. ... People will die.”

That’s because the Republican plan would cut Medicaid over the next decade by $772 billion compared with Obamacare. Those cuts would squeeze rural hospitals already struggling to stay afloat, and they would leave millions of struggling families and their children without medical coverage that Obamacare would have provided.

Republicans prefer to point to different CBO numbers – that the deficit will be reduced by $321 billion over 10 years, or that gross premiums will drop by 20 percent in 2026. But the CBO also says those benefits will come in part because the old and sick will be priced out of the insurance market, or because low-income people will decide that a high-deductible, low-coverage plan is simply not worth it.

All of which is acceptable to most Senate Republicans, who say that Obamacare is failing. Except it’s not. It’s fixable, and doing so would be best for the middle-income 60-year-old in Mecklenburg and Forsyth counties, and for the low-income, the elderly, the family hit with a sudden job loss, the parents of a chronically ill child, and so many others.

It would not, however, help Thom Tillis and Richard Burr and the wealthy to which they are so attentive. That, it seems, is what matters most.