The most affordable plan depends on how much health care is used. Democrats and Republicans are each claiming the bill they’re putting up for a Senate vote Thursday is the more affordable option for tens of millions of Obamacare health insurance customers. It depends on the customer. The GOP plan could save money for healthy, better-off enrollees. For sicker and lower-income enrollees, Democrats’ plan is the more affordable option. Neither the Democratic bill, from Minority Leader Chuck Schumer, or the Republican one, from Sens. Bill Cassidy of Louisiana and Mike Crapo of Idaho, is going to pass, but each side is hoping that offering a plan will save them from voters angry about the spike they’re going to see in their Obamacare premiums next month if Congress does nothing. Larry Levitt, executive vice president for health policy at KFF, a research organization, broke it down for POLITICO. “There are a small number of people who would be better off under the Senate Republican plan, and it would cost the taxpayers less,” Levitt said. “In general, the Senate Democratic plan, while it would cost the federal government more, would make coverage more affordable for a larger number of people.” The Schumer bill would simply extend for three more years the enhanced Affordable Care Act subsidies that Democrats created in 2021. Those made plans free for many low-income people and also offered subsidies for the first time to people earning more than four times the poverty level, capping premiums at 8.5 percent of income. It would cost an estimated $90 billion, according to the Congressional Budget Office. The Cassidy-Crapo bill would let the enhanced Obamacare premium subsidies expire and create incentives for Americans to enroll in higher-deductible Obamacare plans. Americans earning less than 700 percent of the poverty level would receive a deposit in a tax-advantaged health savings account — $1,000 for people ages 18 to 49 and $1,500 for those 50 to 65 — if they purchase a bronze or catastrophic plan on an Obamacare exchange. That policy might benefit people who don’t use much health care or meet their deductible, which for a bronze plan was roughly $7,000 on average last year, according to KFF data. Such people would potentially pay a very low or $0 premium and could then use the $1,000 or $1,500 HSA toward health care expenses. Owners of HSAs can put additional pre-tax money into them and invest the money in stocks and bonds. Withdrawals aren’t taxed if the money’s used on health care, including dental and vision and over-the-counter medications and supplements. The funds don’t expire, and they can be withdrawn for any use after age 65. If the money’s used then for something other than health care, it’s taxed as income. Under Democrats’ plan, healthier individuals enrolling in the ACA could purchase a lower-deductible plan with their enhanced subsidy, but they may be buying more robust coverage than they actually need, without the benefit of the HSA contribution. For people with more complex health needs, who have lower incomes or are older, Democrats’ plan is likely to be the more affordable, safer option, policy experts said. Under Schumer’s proposal to extend the enhanced subsidies — which helped drive record Obamacare enrollment the last four years — those consumers would still be able to purchase silver plans, whose deductibles are lower than bronze, for little to no premium. If they make between 100 and 250 percent of the federal poverty level, they would also get help with deductibles through cost-sharing reductions insurers apply. Lead Art: At a POLITICO event on Dec. 9, Sen. Bill Cassidy (R-La.) argued that most Obamacare consumers would be better off with government-funded health savings accounts, proposed in his plan, over Democrats' proposed extension of enhanced premium subsidies. | Pixelme Studio for POLITICO

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