House Republicans’ proposal to rewrite federal health-care law would more than reverse the gains the Affordable Care Act has made in the number of Americans with health insurance, while curbing the federal deficit, according to a widely-anticipated forecast by congressional budget analysts.
The analysis, released late Monday afternoon by the Congressional Budget Office, predicts that 24 million fewer people would have health coverage over the coming decade, nearly doubling the share of Americans who are uninsured from 10 to 19 percent. But the GOP legislation, which has been speeding through House committees since it was introduced a week ago, would lower the deficit by $337 billion during that time, primarily by lessening spending on Medicaid and government aid to help people buy health plans on their own.
The report predicted that premiums would be 15 percent to 20 percent higher in the first year compared with the Affordable Care Act and 10 percent lower on average after 2026. By and large, older Americans would pay “substantially” more and younger Americans less, the report said.
The 37-page report provides the most tangible evidence to date of the human and fiscal impact of the House GOP’s American Health Care Act. It also undermines President Trump’s pledge that no Americans would lose coverage under a Republican remake of the ACA…
Democrats used the report’s finding to continue attacking the House GOP plan. “The CBO score shows just how empty the president’s promises, that everyone will be covered and costs will go down, have been,” said Senate Minority Leader Charles E Schumer (D-NY). “This should be a looming stop sign for the Republicans repeal effort.”
Specifically, the analysis predicts that the number of people without health coverage would rise to 52 million by 2026, compared with 28 million if the ACA remains intact. That erosion would mean that fewer than one in five US residents would be uninsured by 2026 — compared to one in 10 uninsured now and one in six who were uninsured before the ACA was enacted.
The reduction would result from three factors. A provision rescinding the penalty imposed on the uninsured would prompt many Americans to drop their health plans. After that, tax credits that are less generous than current subsidies would make insurance unaffordable to many more. Finally, some states may undo the expansion of their Medicaid programs…
The measure derives most of its budget savings through cuts to Medicaid, while nearly all of its cost comes from the proposal’s system of tax credits, which would replace the ACA’s federal insurance subsidies.
While the deficit would be lower, the analysis says, the legislation also would reduce federal revenue by $592 billion by 2026 by repealing several taxes that the ACA created to help pay for more people to get insurance — notably taxes on high-income Americans, hospitals. and health insurers.
“I would hope that this would make the Republicans say ‘we can’t do this,'” said Senator Patty Murray (D-WA), a member of Democratic leadership.
“Twenty-four million people lose their coverage, it is total chaos to the country and I hope they pause, say ‘This is not what we should be doing,’ and move on.” …
The Affordable Care Act has increased coverage by 20 million to 22 million — almost half of those through the insurance markets the law created for people who cannot get affordable coverage through a job, and the rest through an expansion of Medicaid in 31 states and the District of Columbia.
According to the report, an estimated 52 million people would be uninsured in 2026, compared with 28 million who would lack insurance that year under the current law…
The estimates projected a significant drop in Medicaid enrollment. Next year, the forecast says, about 5 million fewer people would be on Medicaid. By 2026, the program’s rolls would shrink by nearly 15 million — almost one in four of the 68 million currently in the program.
The CBO also predicted substantial disparities in the effect the legislation would have on insurance premiums for younger versus older consumers.
If the GOP plan is enacted, a 21-year-old making $68,200 would pay an average of $1,450 for a year’s worth of insurance premiums after the new tax credits, compared with $5,100 under current law.
On the other hand, the cost of a year’s worth of premiums would stay about the same for a 64-year-old at the same income level. For a 64-year-old making $26,500, the cost would rise sharply from $1,700 to $14,600…
Senator Bill Cassidy (R-LA) recalled Trump’s promise that the healthcare plan would insure everyone.
“President Trump said that he wants as many people covered as under Obamacare,” Cassidy said. “He said that healthcare should be affordable. If there’s 14 million people losing insurance — of course it’s concerning. I try to avoid hyperbole and adjectives, but it’s concerning.”
–Amy Goldstein, Elise Viebeck, Kelsey Snell, and Mike DeBonis
Obamacare Revision Would Reduce Insured Numbers by 24 Million, CBO Projects