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States that Trump won have lion's share of Obamacare subsidies to lose

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Martin Schutt | AFP | Getty Images

They gave Donald Trump the White House — and now the president-elect could take billions of dollars in Obamacare aid from them.

Data released Monday shows that Obamacare customers who live in many of the states that voted for Trump have the most to lose if the Affordable Care Act and its related subsidies are repealed during his administration.

The Kaiser Family Foundation said that as of March 31, nearly 9.4 million people in the United States were due to receive about $32.8 billion in annual tax credits to help reduce their monthly health insurance premium payments for plans purchased through Obamacare marketplaces.

Half of that dollar amount went to residents of just five states: Florida, California, Texas, North Carolina and Georgia.

And four of those five states — the exception being California — are set to give their Electoral College votes to President-elect Trump, who has promised to dismantle the insurance system.

Of the top 20 states in terms of the value of their total Obamacare subsidies, all but five will give their Electoral College votes for Trump.

"These are some states where a lot of people have opposed the ACA, but it's also where a lot of money is at stake if the ACA is repealed," said Cynthia Cox, associate director of the program for study of health reform, costs, private insurance at the Kaiser Family Foundation.

The ACA provides financial aid to reduce the cost of monthly premiums to Obamacare customers whose annual taxable household incomes fall between 100 percent and 400 percent of the poverty level. For a family of four, that's $24,300 to $97,200.

As of March, the average monthly subsidy for Obamacare customers nationally was $291. The subsidy amount is tied to the retail cost of Obamacare plans — the higher the premiums, the higher the subsidies tend to be.

Alaska had the highest average subsidy — $750. That Trump-supporting state was followed by four others — Wyoming, North Carolina, West Virginia and Louisiana — where the average subsidy is $459, $401, $388 and $362 per month, respectively.

There's currently a "great deal" of assistance going to enrollees who sign up for individual health plans sold through Obamacare exchanges, Cox said. "If that assistance goes away, a lot of insurers would not want to participate in this marketplace."

Cox noted that the data released Monday does not include the additional subsidies that Obamacare customers who earn 100 to 250 percent of poverty level receive to help lower the cost of their out-of-pocket health expenses.

Trump said during the presidential election that he intended to repeal Obamacare if he won the White House and replace the health-care law with something "much better." It remains to be seen what form that replacement will take — and when it would go into effect.

Last week, Trump said he will nominate staunch Obamacare critic Rep. Tom Price, R-Ga., as secretary of the Department of Health and Human Services.

As a congressman, Price has proposed legislation that would fully repeal the ACA. But Price has also called for replacing Obamacare with a system that would, among other things, provide people who purchase health insurance on the individual market with refundable tax credits. Those tax credits would be linked to age, with younger adults getting $1,200 per year, people age 35 to 50 getting $2,100 per year and people older than 50 getting $3,000 per year.