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Analyzing the health care bill
CBO says Senate health care bill would raise costs
A new study by the nonpartisan Congressional Budget Office finds 22 million would lose coverage and costs would rise for many under the Senate’s plan.
WASHINGTON — The health care bill Senate Republican leaders unveiled last week would increase the number of people in the U.S. without health coverage by 22 million and push up medical costs for millions of other poor and sick Americans, according to a new analysis by the nonpartisan Congressional Budget Office.
The report — which comes just days after President Donald Trump called for a bill “with heart” — outlines how the GOP plan would cause a widespread erosion in basic health protections, driven by more than $1 trillion in cuts to federal health care spending over the next decade.
Some consumers “would experience substantial increases in what they would spend on health care,” the budget office analysis said. Because individual insurance under the Senate bill “would pay for a smaller average share of benefits,” it found, “most people purchasing it would have higher out-of-pocket spending on health care than under current law.”
The report heightens the political challenge for Senate Republican leaders, who are scrambling to lock down votes to advance their Obamacare repeal bill this week before Congress adjourns for its July 4 recess.
The legislation, developed in secret by Senate Majority Leader Mitch McConnell, R-Ky., has been public since only Thursday.
Now, in the face of condemnation from patient advocates, physicians, hospitals and others, several GOP senators are fretting about the bill’s impact.
Senators have said the report from the budget office, which Congress has traditionally relied on for estimates of the impact of major legislation, would be important to their decision on how to vote.
A key moment could come as early as Wednesday with a procedural vote allowing the Senate to begin debate on the bill. It remains unclear if McConnell can muster the 50 senators he would need to prevail.
On Monday, the American Medical Association added to the pressure, sending Senate leaders a blunt warning: “Congress should be working to increase the number of Americans with access to quality, affordable health insurance instead of pursuing policies that have the opposite effect,” the medical group said.
The new budget office report suggests the effects of the Senate bill would be particularly hard on millions of low- and middleincome Americans, as it forces states to scale back their safety nets and prompts insurers to pare down benefits and raise deductibles in response to weakened regulations.
“The share of services covered by insurance would be smaller,” the report concludes. That, coupled with high deductibles, would drive many consumers from the market. “Few low-income people would purchase any plan,” the analysts concluded.
For example, a 40-yearold American with an income of $26,500-a-year would see his or her annual insurance premiums nearly double to $3,000, the budget office found. A 60year-old with same income would see premiums nearly quadruple to $6,500.
Americans making even less might only be able to buy health plans with deductibles that were half their annual incomes.
By contrast, higher-income Americans and a number of industries, including health insurers and medical device makers, would reap windfalls as the bill wipes out about $700 billion in taxes over the next decade, according to the budget analysis.
The analysis was similar to what the budget office said regarding the version of the bill which passed the House last month. That bill would reduce insurance coverage by about 23 million people over the next decade, the budget office said. The Senate measure would have slightly less impact on overall coverage, but would involve deeper, long-term cuts in Medicaid than the House measure.
Over the last four years under the Affordable Care Act, the share of people without coverage in the U.S. has been cut in half, dropping to the lowest levels ever recorded, data show. Much of that reduction has been driven by expanding Medicaid.
The centerpiece of the Senate Republican bill is a series of measures that would reverse that trend, imposing a $772 billion dollar cut in Medicaid spending over the next decade.
The federal government under the Republican bill would pull back aid to states for the half-century old government health plan which currently covers some 75 million low-income people, including children and the elderly in nursing homes.
The bill would end the expansion of Medicaid coverage made possible by the current law. Federal assistance for expanded Medicaid would be phased out beginning in 2020 and shut down completely by 2023.
Additional money in the Senate bill to prop up insurance markets over the next several years may keep them stable in the short term, the CBO concluded.
And a last-minute change to the bill added Monday that would replace Obamacare’s unpopular requirement that people buy insurance may also help get some additional customers to enroll in coverage, though the budget office concluded the Senate bill’s replacement for that would have relatively little effect.
The Senate measure would now impose a sixmonth waiting period for coverage on consumers who go without health insurance for more than two months.
That’s designed to prevent people from waiting to buy insurance until they find out they are sick. But its effect will be to lock some seriously ill people out of coverage for months.