Republicans like Donald Trump and Mitch McConnell have often pointed to the high insurance deductibles that Americans face under Obamacare as evidence of the health reform law’s failure. This has always been an awkward and transparently cynical line of attack, since basically every replacement plan Republicans have floated over the years has been designed to allow insurers to sell cut-rate coverage with even higher deductibles. This is no less true of the proposal now making its way through the House of Representatives, which is designed to let carriers sell plans that cover less of their customers’ health costs.
And so, in the brave new world of Trumpcare, average deductibles are almost certainly going to go up. In a column at Axios, Kaiser Family Foundation President Drew Altman estimates that the deductible in a “typical plan” will rise about $1,550, from $2,150 to to $4,100. He bases this calculation on the Congressional Budget Office’s projection that the average “actuarial value” of insurance plans on the individual market—how much of customers’ expenses they cover, on average—will fall from 72 percent to 65 percent.
Now some Republicans might look at this and say something like, “Great. Under Obamacare, Americans are required to buy high deductible plans. Under Trumpcare, they’ll be able to choose cheap coverage that fits their needs!” If you encounter this argument in the wild, please respond with a withering stare. One of the major reasons Americans will have to choose cheap coverage under Trumpcare is that Republicans are cutting funding for premium tax credits and eliminating the “cost-sharing reduction” subsidies that lower deductibles for low-income households. Furthermore, because Trumpcare will allow insurers to sell skimpy plans without also offering more robust options—Obamacare forces them to sell both in order to participate on the markets—a lot of Americans will have few choices to pick from. If this bill passes, expect that a whole lot of people won’t have any option but to pay more for worse coverage—if they can afford any coverage at all.