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Cities That Will Fare the Worst Under the AHCA's Tax Credit Plan

Laura Joszt
The Republican healthcare law repeals several provisions in former President Barack Obamaís health law; however, while the GOP's American Health Care Act does provide financial assistance, similar to the Affordable Care Act (ACA), Americans will find that those dollars donít go as far as they did under the ACA.
The Republican healthcare law repeals several provisions in former President Barack Obama’s health law, but like the Affordable Care Act (ACA), the GOP's American Health Care Act (AHCA) does provide financial assistance. However, Americans will find that those dollars don’t go as far as they did under the ACA.
One of the key differences in the financial assistance is how it is allotted. Under the ACA, subsidies were determined based on a number of things, including the cost of healthcare in the local market and how much an individual’s income could purchase. This meant that someone in Anchorage, Alaska, and someone in New York City could make the same income, but receive different subsidies: the person in Alaska would receive more because the market was more expensive.
However, under the AHCA, the tax credits are based on age. This means that the same 2 individuals could receive the same amount of money if they are the same age, providing a distinct disadvantage to the person living in Anchorage.
A new WalletHub report assessed the impact of the AHCA by comparing 457 cities and comparing the ACA subsidies that a 2-person household earning the median income with both members of median age for each city would receive with the tax credit that a 2-person household with both members the median age for each city would receive under the AHCA.
“If the goal of the AHCA is to increase access to affordable health insurance, at a minimum, the subsidies should be tied to income to better assist low-income and older people in being able to afford coverage…” Elena M. Marks, nonresident fellow in health policy at Baker Institute, told WalletHub for the report.
The ranking was created using data from the US Census Bureau and Kaiser Family Foundation.
10. Asheville, North Carolina
Subsidy Difference: –$4232
The median age in Asheville is approximately 38 years old, which means that the theoretical household being considered for this report would receive a $5000 tax credit. However, under the ACA, this household would have received a much larger subsidy: $9232.
In general, North Carolina doesn’t fare well. The state has another 2 cities that landed in the top 10, while another 2 landed at eleventh (Greensboro) and thirteenth (Winston-Salem).

9. Wichita Falls, Texas
Subsidy Difference: –$4434
Wichita Falls skews a little younger than Asheville with a median age of approximately 32 years. As a result, the household being considered would also receive $5000 despite the fact that under the ACA, it would have received $9434.
This is the only city in Texas in the top 10. Overall, 7 cities in Texas will see a reduction in subsidies received, while another 38 will see an increase under the AHCA.

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