A health care advocacy group targeted two dozen House Republicans who voted for the American Health Care Act, including Florida Reps. Carlos Curbelo of Miami and Brian Mast of the Treasure Coast, in a new ad.
The mostly digital ad by Save My Care says the health care bill will lead to skyrocketing costs for older consumers.
"Congressman Curbelo just voted for a disastrous health care repeal bill opposed by the American Medical Association, AARP and the American Cancer Society," the ad says. "Curbelo voted to raise your costs and cut coverage for millions, to let insurance companies deny affordable coverage for cancer treatment and maternity care, and charge five times more for people over 50."
Formed in 2016, Save My Care is affiliated with Eric Kessler, a former White House appointee who helped to manage conservation issues during Bill Clinton's administration.
For this fact-check, we wanted to hone in on whether the American Health Care Act allows insurance companies to "charge five times more for people over 50."
This line is partially accurate but leaves out important details. We rate it Half True.
There is a provision that allows insurance companies to charge five times more for consumers ages 50 to 64 buying insurance on the individual market.
Some viewers might assume the five-fold increase starts from zero. What the ad doesn't tell you is that insurers can already charge older people more than younger adults — three times as much.
Also, this doesn't apply to seniors on Medicare, or people between 50 and 64 years old with employer-sponsored coverage.
Rate banding happens
The House bill increases the 3-to-1 "rate banding" ratio under current law up to five times starting in 2018, unless states set a different age ratio.
Before the Affordable Care Act, nicknamed Obamacare, premiums for older adults were typically four or five times the premiums charged to younger adults, according to the Kaiser Family Foundation.
That more accurately reflects the actual higher costs spent for older adults' health care, said Linda Blumberg, an Urban Institute health policy expert.
The lower age ratio in President Barack Obama's health care law was a better deal for older adults. The goal was to make coverage cheaper for older adults regardless of health status.
The Rand Corporation, which evaluated an earlier version of the American Health Care Act, found that older adults would pay more than current law if the House bill with the 5-to-1 rate banding becomes law. (The research was funded by the Commonwealth Fund, which aims to increase health care access for the poor.)
The increased costs would occur, according to Rand, as a result of tax credits in the House bill not increasing with age as steeply as premiums.
Young people, however, would get a break on premiums.
Other cost drivers
The change in age ratios is just one provision of the House proposal that affects costs for older adults.
Here's another: The legislation would replace the current income-based tax credits with a credit based on age.
For adults over 60, that would mean a $4,000 credit.
For adults under 30, the credit would be $2,000.
The legislation phases out tax credits for individuals who make more than $75,000 annually (or a couple who files jointly earning $150,000).
Older, lower-income residents and people who live in high-premium states such as Alaska and Arizona would generally receive less financial assistance in the House proposal, according to a Kaiser analysis.
A Congressional Budget Office analysis of an earlier version of the American Health Care Act, or AHCA, concluded that it would disproportionately increase the number of uninsured ages 50 to 64 with incomes less than 200 percent of the poverty limit. (The final legislation has not yet received a CBO score.)
For example: Under current law, a 64-year-old with an income of $26,500 would pay a net premium of $1,700 after factoring in a tax credit.
Under the House bill, according to CBO, that person's premium rises to $14,600.
Older Americans could see more changes if states choose to redefine essential health benefits for coverage in the individual market.
"I cannot imagine a scenario where the AHCA is not worse for older adults than the ACA," Blumberg said.
Curbelo's spokeswoman told us Curbelo has called for revisions to the bill that he voted for that increase tax credits for low-income Americans and for people approaching retirement.
Read more rulings at PolitiFact.com/florida.