The new Senate bill's major provisions

[stpioc]

The CBO report is a dense 49-page document that you can read here. But you can find its clearest explanation of the Senate bill on page 48. This is where the CBO report explains how premiums would change for low- and middle-income Americans — and what type of health insurance they would get for those monthly payments.

This page shows, in no uncertain terms, that low-income Americans would be asked to pay higher premiums for worse health insurance coverage. Look at what happens to people who earn $26,500 (175 percent of the poverty line). I've circled the most relevant numbers below.





You can see that across the board, premiums go up for Americans with low to moderate incomes. People who purchased bronze-level plans would see their premiums go up a little. People who purchased silver-level plans would see their premiums go up a lot.

What is harder to see is that the premiums are up while the quality of the health insurance is going down. Those numbers in the gray boxes represent actuarial value, which measures how much a health plan, on average, covers of its members' costs. You can see that the actuarial value drops as premiums rise. This, in simple terms, means enrollees will be asked to pay higher premiums and in return get coverage with higher deductibles and copayments.

The reality, of course, is that many of these people just wouldn't buy coverage. They would find the plans prohibitively expensive and the coverage not worth the price. This is what the CBO concludes in one especially devastating paragraph (bolding mine):

Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income — also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

Page 48 is the most important page in the CBO report - Vox