Bill cost study expectations low

Fewer Americans to have health coverage

WASHINGTON, March 13, (AP): Republicans pushing a plan to dismantle Barack Obama’s healthcare law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump’s promise of “insurance for everybody.”

House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured.

But Ryan and Trump administration officials vowed to move forward on their proposed “repeal and replace” plan, insisting they can work past GOP disagreements and casting the issue as one of “choice” in which consumers are freed of a government mandate to buy insurance.

“What we’re trying to achieve here is bringing down the cost of care, bringing down the cost of insurance not through government mandates and monopolies but by having more choice and competition,” Ryan, R-Wis., said on Sunday. “We’re not going to make an American do what they don’t want to do.”

The CBO’s long-awaited cost analysis of the House GOP leadership plan, including estimates on the number of people expected to be covered, will likely affect Republicans’ chances of passing the proposal.

GOP opponents from the right and center are already hardening their positions against the Trump-backed legislation. House conservatives vowed to block the bill as “Obamacare Lite” unless there are more restrictions, even as a Republican, Sen. Tom Cotton, R-Ark., warned the plan would never pass as is due to opposition from moderates.

“Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote,” Cotton said. “If they vote for this bill, they’re going to put the House majority at risk next year.”

Trump was bullish about Republican chances of passing a healthcare bill, tweeting Monday, “Republicans will come together and save the day.”

“ObamaCare is imploding. It is a disaster and 2017 will be the worst year yet, by far!” he tweeted.

The GOP legislation would eliminate the current mandate that nearly all people in the United States carry insurance or face fines. It would use tax credits to help consumers buy health coverage, expand health savings accounts, phase out an expansion of Medicaid and cap that program for the future, end some requirements for health plans under Obama’s law, and scrap a number of taxes.

Coverage

During the presidential campaign and as recently as January, Trump repeatedly stressed his support for universal health coverage, saying his plan to replace the Affordable Care Act would provide “insurance for everybody.”

On Sunday, his aides took pains to explain that a CBO finding of fewer people covered would not necessarily mean that fewer people will be covered.

“If the CBO was right about Obamacare to begin with, there’d be 8 million more people on Obamacare today than there actually are,” said Mick Mulvaney, director of the White House Office of Management and Budget, disputing the accuracy of CBO data. “Sometimes we ask them to do stuff they’re not capable of doing, and estimating the impact of a bill of this size probably isn’t the best use of their time.”

Meanwhile, a non-partisan report expected as soon as Monday on the costs of a Republican plan to replace the Obamacare healthcare law could harden opposition to the proposal, adding to the obstacles facing Trump’s first major legislative effort.

The Congressional Budget Office, which provides official cost estimates for legislation, is widely expected to find the Republican plan will result in fewer Americans with health insurance than under the Affordable Care Act, former Democratic President Barack Obama’s signature domestic legislation.

Just days before taking office in January, Trump promised “insurance for everybody” in his Obamacare replacement.

The House Republican legislation would also roll back an expansion of Medicaid insurance for the poor, and replace Obamacare’s income-based subsidies with a system of fixed tax credits to help people buy private insurance on the open market.

The credit rating agency Standard & Poor’s has estimated 6 million to 10 million people could lose health insurance under the Republican plan, known as the American Health Care Act.

It would cancel tax revenues worth at least $600 billion over 10 years, according to Congress’ Joint Committee on Taxation.

The CBO report is needed to determine the full budgetary impact of the legislation – whether the savings from the Medicaid cuts and lower subsidy costs are enough to offset the loss of tax revenues.

Republicans have long opposed Obamacare, saying it was government overreach and led to higher insurance premiums. Trump, a Republican, has called the law a “disaster” and made its repeal and replacement a key campaign pledge.

Democrats and some influential Republicans say the legislation to replace Obamacare would rip health insurance away from millions of Americans and increase costs for many others. The 2010 law provided 20 million previously uninsured Americans with health coverage.