Quick Look: Portland Would Fare Better than Rural, Eastern Oregon Under Republican Obamacare Replacement

Higher earners would fare much better– but only up to a point– under Trump-backed Obamacare replacement

The cuts and gains Oregonians would face under the American Health Care Act proposed by Republicans in the U.S. Congress seem almost arbitrary at times.

Across the state, residents are divided among eleven pricing tiers. The so-called “Trumpcare” proposal offers tax credits based on the local poverty line, and on the age of each person, making it incredibly complicated to calculate how any particular person or family might be affected, according to a Lund Report review of data compiled by the Kaiser Health Foundation.

Starting in 2020, of people buying health insurance for just themselves, those earning $75,000 per year would get the biggest tax benefit, while those earning $100,000 or more would generally get a small benefit or break even.

Meanwhile, in every county in Oregon, people earning $20,000 per year and buying individual health insurance would lose out. The extra annual cost varies by age and location – a 60-year-old resident of Malheur County with income of $20,000 would lose $9,760 in tax credits under the Obamacare replacement plan, while a 40-year-old living in Portland on $20,000 would lose just $450 in tax credits.

Unlike many “tax credits,” these cuts to the help offered under the Affordable Care Act would have real consequences for people buying their own health insurance. Though a Portland resident earning $20,000 in 2017 with no special deductions would owe at most about $2,500 in federal income tax plus Social Security and Medicare taxes, they could receive a direct payment under the ACA of as much $8,410 to help pay for an insurance policy. That would fall to a maximum of $4,000 in assistance starting in 2020, under the Republican plan.

This analysis only looks at the effects on people buying their own health insurance. The Republican plan would also cut Medicaid funding, which would force drastic cuts to funding for Oregon's coordinated care organizations, which serve the poorest people in the state.

Click here to see how every county in Oregon would fare, with a breakdown by income level and age.

Baker, Crook, Grant, Harney, Jefferson, Malheur, Umatilla. Union and Wallowa counties:

Residents of some of the most sparsely populated, poorest regions of the state would also see the biggest losses under the American Health Care Act, with poor seniors especially hard hit. This tier includes the easternmost third of Oregon, stretching from Nevada, along the Idaho border, and up to Washington state.

Benton, Clackamas, Columbia, Hood River, Linn, Marion, Multnomah, Polk, Washington and Yamhill counties:

Residents of the state’s most urban and wealthiest rural areas -- the greater Portland area, the Willamette Valley, the Columbia River Gorge, Salem, Eugene and Corvallis, and their surrounding areas, would in general lose less or gain more than residents of most of the rest of the state. Columbia County, largely rural but including outer edges of the Portland metro area, and Polk County, which includes portions of greater metro Salem, are also in this tier.

Click for The Lund Report's in-depth analysis.

Reach Courtney Sherwood at sherwood@thelundreport.org.