Here’s how the Republican healthcare bill would affect Tyler

Next week, Senate Republicans will try to pass a new healthcare bill to undo much of Obamacare. The Better Care Reconciliation Act of 2017, also known as the AHCA, will no longer require everyone to have health insurance, and also slashes benefits many vulnerable Americans rely on. It may be one of the most unpopular bills ever written.

If the bill passes, what does it mean for people here in Tyler, a city where healthcare is all around us? Let’s take a look.

Throughout this post we’re relying on excellent analysis of the bill by The Washington Post, NPR, and The Kaiser Family Foundation to help us understand its potential impacts.


Funding for Medicaid, a federal healthcare program for low-income families, will be slashed. According to the US Census, an estimated 42 percent of kids in Smith County pay for all their healthcare through Medicaid. If this bill passes, Medicaid families will have fewer services available starting in 2021.

Obamacare gave states an option to get more Medicaid funding, but Texas chose not to sign up. That means we’re not affected by the AHCA’s rollback of that increase; we never got it to begin with.


Working-age adults will pay more for healthcare, especially those over 50. Under Obamacare, your insurance policy couldn’t cost more than 9.5 percent of your total income. So, if you made $45,000 a year, your insurance would never cost more than $4,300 a year.

Under the Republican bill, that number will get higher the older you get. If you’re between 59 and 64 years old, your insurance policy can cost up to 16 percent of what you earn in a year. So, if you earn $45,000 a year, your insurance could now cost up to $7,300.

Large companies will no longer have to offer health insurance to their employees. The share of local working-age adults who get healthcare through their jobs has gone up in recent years. Between 2009 and 2015, it jumped from 51 percent to 58 percent. If those workers have jobs at big companies, and their employers decide to stop offering health insurance, they’ll need to find a new way to pay for their healthcare.

Sick people

If you have what’s called a “pre-existing condition,” meaning you were sick or diagnosed with certain medical problems in the past, you might find it harder to get health insurance if this bill passes. Under Obamacare, insurance companies couldn’t reject you or charge you more if you had a pre-existing condition. Under the Republican bill, Texas and every other state will get to decide whether or not to keep following that rule.

According to the Kaiser Family Foundation, more than half of American households include at least one person with a pre-existing condition.

Mental health

If you or someone in your family needs mental health services, and you’re on Medicaid, you should know that the Republican bill allows Medicaid to stop covering that care. Here in East Texas, we already have fewer mental health services than we need.

The rich

If you own a business, or you make more than $200,000 per year, you and/or your company will receive a tax cut if this bill passes. Obamacare raised taxes on corporations and wealthy people to pay for more healthcare services. The Republican plan will drop those tax rates back to what they were before Obamacare.

Here in Tyler, about 1 in 20 households earns more than $200,000 a year. The most common profession among those high earners? Doctors.

What’s next?

None of these changes are a done deal. Republican Senate leader Mitch McConnell wants the Senate to vote on the bill before the 4th of July break. That means voters have less than a week to make their voices heard. Though Texas seems like an unlikely swing vote, senators John Cornyn and Ted Cruz seem to have different opinions about the bill, so a surprise upset isn’t totally out of the question.

Few Americans won’t be affected, in some capacity, by the passage of this bill. Whether you like your current healthcare coverage or you hate it, now is an opportunity to get informed and speak up about what you need.

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