Under the proposed plan, thousands of Georgians who live in rural areas that voted overwhelmingly for Trump – by a whopping 75 to nearly 90 percent in some cases – could lose out on thousands of dollars in tax credits to help them buy health coverage, an analysis by The Atlanta Journal-Constitution has found.
Without it, experts say, many would have to pay far more and possibly be forced to drop health coverage altogether.
Those hardest hit: people 60 years or older making between $20,000 and $40,000 a year, according to an AJC analysis of data compiled by the nonprofit Kaiser Family Foundation. It compares how tax credits proposed by the GOP plan size up against what people get under Obamacare.
It’s a vulnerable age for many working class Georgians. They increasingly suffer from multiple — and expensive — chronic conditions like arthritis and heart disease. But they aren’t old enough to qualify for Medicare, the government health program for Americans age 65 and over.
MAP: Georgians hit by tax credit change
MORE: Thousands of Georgians could lose coverage
Nationwide, the Republican proposal could lead to 24 million Americans losing their health insurance in the coming decade, the Congressional Budget Office estimates.
President Trump on Wednesday seemed to acknowledge that some of his most ardent supporters would likely lose out under the plan.
What You Need To Know: American Health Care Act
Fox News’ Tucker Carlson questioned Trump about the plan, saying a recent Bloomberg report showed “counties that voted for you – middle class and working class counties – would do far less well under this bill.”
“Yeah. Oh, I know that … I know,” Trump responded. He called the health plan “very preliminary.”
Carlson pushed him further, saying, “It seems like maybe this is inconsistent with the message of the last election.”
“A lot of things aren’t consistent, but these are going to be negotiated,” Trump said. “We’ve got to go to the Senate. We’re going to see what happens in the Senate.”
Trump added: “We will take care of our people, or I’m not signing it.”
‘It was supposed to be better’
Kenneth Peek is among many Trump supporters in South Georgia coming to terms with the new GOP proposal, called the American Health Care Act, and learning they could be worse off.
Make no mistake, many people here still love Trump. They remain hopeful he will bring about reforms that reduce health care costs, open up competition and help rural areas like theirs.
Kirk Lyman-Barner, left, is an insurance agent in Americus who specializes in Obamacare policies. He is pictured outside his office with his wife, Cori. They also are enrolled in an Obamacare policy and worry that the proposed GOP health care plan would cost them more.
Much of that support is driven by widespread disdain for Obamacare. Many see it as an entitlement that often benefits people not willing to pull their own weight.
Worse, they resent Obamacare’s mandate that people buy health insurance, seeing it as a directive at home in a repressive regime, not a democracy. Even some with Obamacare insurance have complained their premiums have grown by double-digits in recent years and deductibles are so high that their coverage is basically worthless.
Right now, Peek is paying $281 a month for his health policy through Obamacare. That’s $3,372 a year. He’s receiving $11,172 in government tax credits. (His wife, Debra, is on disability.)
ANALYSIS: How Georgians could lose out
Under the proposed new plan, his tax credit would shrink to about $4,000, a drop of $7,172 or 64 percent.
The tax credits are designed to help people who don’t get coverage through an employer buy individual insurance. Both Obamacare and the GOP plan offer them but in very different ways.
The Obamacare credits are based on income, so people who make less benefit more. Under the GOP plan, people would receive credits based mostly on their age, not their income. So a 40-year-old making $30,000 and a person the same age making $50,000 would receive the same flat sum of $3,000.
Peek, for his part, is disappointed, and concerned he might not be able to afford health insurance.
“The way they talked it was supposed to be better,” Peek said.
But his support for Trump remains. He likes the president’s efforts to tighten-up the nation’s borders and add muscle to the military.
Still, the way health care reform is going reminds him of something his daddy told him years ago.
“Anything the government gets involved in, it’s going south.”
Keep government out of health care
Ellaville is a little place tucked away off U.S. 19, about a 2 1/2-hour drive south of Atlanta. It serves as the seat of Schley County with its population of barely more than 5,000.
Ellaville is the county seat for Schley County in South Georgia. The downtown area sits in the shadow of the county courthouse.
Around here, Obamacare is just about a dirty word.
Some 77 percent of people in Schley — pronounced as Sly — voted for Trump in the presidential election. Trump drew widespread support from white, working-class people across the country. This county is 73 percent white, and the median household income is $39,375, well below the national figure of $56,516.
Ellaville’s downtown is a short stretch bounded by a brick courthouse with a clock tower on one end and the Piggly Wiggly on the other. There’s only one traffic light.
It’s lunchtime at the Main Street Grill. The place has a rusted metal sign swinging above the front door. There’s a TV that plays Fox News a lot. On the wall, there’s a sign from the original Ellaville High School and photos of teens who worked here before going off to the military.
Blake Yelverton is taking a break with a burger that doesn’t cut any corners. Cheese and bacon and everything. He’s 23, a burly young man with a big red beard, and he works on his father’s cow farm.
“I don’t believe it’s the federal government’s job to provide health care,” he said. “It’s communism, socialism anyway.”
Yelverton hopes Trump trashes the whole thing, and he’s not too fond of the GOP plan being discussed in Congress either. “They’re doing a lesser evil of Obamacare,” he said.
“I’m on my parents’ plan,” he said.
So, Yelverton, it turns out, benefits from Obamacare. That’s because the law allows parents to keep kids on their insurance until age 26 — a widely-popular element of Barack Obama’s signature health law that Republicans intend to keep in their replacement plan.
Confronted with that information, he pauses for a moment.
“I haven’t been to the doctor in four or five years,” he said.
While some would be hammered financially under the GOP plan, there would also be winners.
Thousands of Georgians, mostly those who are younger and better off financially, would come out ahead under the GOP plan.
Right now, most individuals who make roughly $50,000 or more make too much to qualify for tax credits under Obamacare. The new health plan offers credits of $2,000 to $4,000, depending on the person’s age, to people making up to $75,000. (Those who make more may also qualify for some financial help.)
Under the GOP plan, a 27-year-old would get $2,000 a year to buy insurance, versus getting nothing from Obamacare.
House Speaker Paul Ryan contends the proposal will lower premiums and improve access to affordable care while providing tax relief and reducing the federal deficit by nearly $340 billion.
Democrats and consumer advocates argue it benefits the wealthy to the detriment of the poor.
‘There’s a lot of prayers here’
The people of Ellaville are proudly unpretentious. They know a lot of people in Atlanta think they are, as Yelverton says, “straight up hicks down here.”
But they believe this place is great in the ways that matter most. Good schools, safe streets, people who come through for one another.
When someone’s child died, they held a fundraiser for the family. When the Peeks’ farmhouse burned down on Christmas Eve 1983, people came together and raised money.
“Everybody was worried about us having Christmas,” Debra Peek said. They donated gifts and clothes for the kids and money for the family to get by. “When people pray for you, you can feel those prayers. There’s a lot of prayers here.”
Behind the Grill’s cash register stands owner Duane Montgomery. He was born and raised in Ellaville, and he also serves as the fire chief and head of emergency management services. His mom, Shirley, helps serve customers seated around the eight tables. She’s retired, and helps out when she wants to.
Duane has strong views on today’s health care problems, shaped greatly by his work with the county fire and EMS department. He’s seen two hospitals in the area close in recent years. So he’s hoping Trump helps out the rural areas, which he says really need more health care.
Joel Veatch is the owner of the Piggly Wiggly in the South Georgia city of Ellaville. He believes health reform should address the widely varying prices for services in hospitals.
Over at the Piggly Wiggly, owner Joel Veatch is helping stock shelves. Another Trump supporter, he hopes Congress repeals Obamacare.
He thinks reform should start with the hospitals. When Veatch had to go for a stress test, a hospital in Albany said it would cost $6,000. He checked with another in Columbus, and it said $1,600.
“If there’s that much variance in cost, then something’s wrong,” he said.
Veatch may be in for a sad surprise. Health care providers and consumer advocates fear the GOP plan will only worsen the problems that put so many rural hospitals in the red.
A recent analysis by Georgia State University estimated 750,000 Georgians could lose their health insurance under the proposal. Such a scenario could send the state’s rate of uninsured people — the third highest in the nation — soaring.
Georgia hospitals already provide $1.75 billion a year in free care to the uninsured. Trying to care for a flood of newly uninsured patients could force some already struggling rural hospitals to close their doors.
‘What happens now?’
Across wide swaths of rural Georgia, the future of health care remains largely uncertain.
Rural lawmakers seem to be at as much of a loss as the residents they serve.
Rep. Butch Parrish, R-Swainsboro, said he’s concerned about the impact the GOP health plan could have in his east Georgia community. So many hospitals and other health care providers in rural areas are “just hanging on,” and more people without insurance would just make things worse, Parrish said.
“The devil is in the details, and we haven’t gotten all the details yet,” he said of the Republican plan. “We’re not sure where this is going to take us.”
Campaigning on repealing Obamacare is one thing, said Rep. Dominic LaRiccia, a Republican from Douglas. Getting up to Washington D.C. and actually doing it is something else, he said.
“Our concerns are the same as the people we serve,” LaRiccia said. “What happens now?”
The GOP plan is expected to head to the House floor for a full vote this week, but with numerous hurdles ahead, it is far from a done deal.
Hard-line conservatives in Congress oppose the plan, saying it doesn’t go far enough. Any replacement, they say, should do away with all of Obamacare, not just pieces of it.
Meanwhile, more moderate Republicans in the House and Senate from states that expanded Medicaid, the government health program for the poor, under Obamacare, worry many of their constituents could lose coverage.
Trump met with a dozen or so conservative lawmakers on Friday to discuss the plan, winning over one of Georgia’s two Republican holdouts.
“I think we’re on an upward path,” said U.S. Rep. Barry Loudermilk, R-Cassville. “There still will probably be a few changes along the way, but I think those changes are just going to improve the bill for conservatives like me.”
Georgia Republican Rep. Jody Hice has also opposed the plan.
But it’s still unclear whether Ryan will be able to garner enough support among his own party to pass the plan. Changes have already been proposed to help bring more conservatives on board. And even if it does pass the House, the plan could ultimately be dead on arrival in the Senate.
‘I had another beer’
Kirk Lyman-Barner is not just an insurance broker who sells Obamacare policies. He’s also a client.
A few years ago, as Obamacare was coming on the market, Lyman-Barner was working for a nonprofit that helped poor people with housing. He had a background in insurance, and he noticed that many brokers were staying away from selling Obamacare policies.
But Lyman-Barner saw the government health care program as “an amazing opportunity to help folks.”
So he went back to selling insurance in 2014, and opened an office in his hometown of Americus. It’s located in Sumter County, adjacent to Schley County. It’s still South Georgia, but Americus is a very different place than Ellaville. With some 16,000 people, it has more of a small-city urban flavor, even as it works to preserve its heritage.
Lyman-Barner’s business took off. Last year he made $70,000 in commissions.
But these days he sees Obamacare under stress. Insurance companies — faced with more sickly and expensive consumers than anticipated — have had to pay out more and, in turn, have cut back on commissions to brokers. This year, Lyman-Barner expects to manage just as many policies but only earn $20,000 in commissions.
The GOP plan worries him personally and professionally. The other night he discovered he would lose $9,040 in tax credits under the new plan.
The insurance salesman realized he might not be able to afford health insurance. His head started spinning. How would he continue to protect his three college-age children? And what about his wife, who has autoimmune issues?
His clients, facing their own problems, might drop their policies.
His reaction: “I had another beer.”
Shafts of sunlight slice through dark clouds over Kenneth Peek’s farm, making it look like a religious painting.
“God’s country,” his wife Debra calls this place, where the eye can range for miles and miles over green earth.
The Peeks love this farm, so much so that when their farmhouse burned 34 years ago, they put down a double-wide trailer and made do.
Looking ahead, they see more years here. The four kids are all grown. They help out when things get busy. Staying healthy, the couple realizes, is essential to keeping the farm going.
Health costs are never far from their thoughts. Debra had a heart attack about three years ago, so she’s now on disability.
Kenneth’s best bet, he thinks, is to simply reach the age of 65 in September, and qualify for Medicare. And hope that nothing changes for the worse till then.
You can see the love between them when they speak. She does most of the talking. When he says something, it’s either important or funny.
“People ask us what it takes to make a happy marriage,” Debra says.
Her husband pipes up the answer.
— Data specialist Saurabh Datar and staff writers Aaron Gould Sheinin and Tamar Hallerman contributed to this report.