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Wisconsin leaders still grappling with effect of health care bill

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MADISON, Wis. (AP) -- Wisconsin health care leaders and policy makers are grappling with the implications of the fast-moving House Republican health care overhaul bill, even as changes are being proposed to blunt its impact on older people.
 
Republican Gov. Scott Walker's administration has been working since last week on its own breakdown of what the proposal would mean to the state and the 242,000 people who purchase federally subsidized private insurance through the marketplace. About 85 percent of them receive a subsidy to purchase insurance, making them vulnerable to reductions in federal assistance.
 
Several analyses indicate that reductions in federal subsidies would force higher rates for Wisconsin residents buying private insurance, particularly older people and those in rural areas.
Wisconsin Department of Health Services spokeswoman Julie Lund said Tuesday that the state's analysis of the bill's impact is still being finalized.
 
Walker told reporters on Monday that he believed the replacement to the Affordable Care Act, championed by House Speaker Paul Ryan, was "moving in the right direction" by improving benefits for older people. But Walker didn't specifically say how he hoped those tax credits would be altered.
 
 Ryan unveiled changes late Monday he hoped would shore up support for the plan to clear the House on Thursday. And President Donald Trump on Tuesday met privately with House Republicans to urge their backing.
 
 Republican support wavered last week when a nonpartisan congressional analysis projected the measure would strip coverage from 24 million people in a decade. The Congressional Budget Office also said the bill would cause huge out-of-pocket increases for many lower earners and people aged 50 to 64.
 
That report did not break out the numbers by state.
 
Democratic staff members of the Joint Economic Committee in Congress released a 50-state study of the bill last week that determined more than 129,000 people in Wisconsin would lose their health insurance next year -- purchased either through their employer or the private marketplace -- under the GOP overhaul.
Premiums would increase by between $682 and $910, for a 40-year-old non-smoker buying a benchmark "second-lowest cost silver plan," the Democratic report said.
 
A separate Associated Press analysis looked at the impact of the proposal in all 50 states on older people who are not yet eligible for Medicare. The GOP plan as introduced would shrink the tax credits people age 50-64 use to help buy insurance and it would increase their premiums because insurers could charge more as people age and become more susceptible to health problems.
 
The AP analysis of data from the Kaiser Family Foundation found that a 60-year-old person in Wisconsin earning $30,000 a year would have to pay $4,640 more per year for coverage than they do now. That same person making just $20,000 a year would have to spend $6,160 more, according to the AP study.
 
The liberal health care advocacy group Citizen Action planned to release its own report Tuesday showing "shockingly large premium increases" for older, moderate income people in 15 Wisconsin cities.
 
Ryan attempts to lower the costs for older people with changes he unveiled late Monday that would allow the Senate, if it chooses, to make tax credits more generous for that age group.
 
Wisconsin Democrats have been united against the measure, which would also cut open-ended federal payments to help states cover Medicaid costs.
 
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