CBO HAS ITS SAY ON ACA REPEAL

Ending Obamacare would add 32M to ranks of uninsured

WASHINGTON A bill the Senate plans to vote on next week to repeal parts of Obamacare without a replacement would make the insurance market unstable, raise premiums and increase by 32 million the number of uninsured people, according to an analysis released Wednesday by the non- partisan Congressional Budget Office.

While repealing billions of dollars in taxes imposed under Obamacare to pay for expanding health coverage to millions more Americans, the legislation would still decrease deficits by $ 473 billion over 10 years because of the spending reductions.

The repeal bill is similar to one approved by the House and Senate in 2015 but vetoed by thenpresident Barack Obama.

The legislation would immediately end the Affordable Care Act mandates for people to obtain insurance and employers to offer it and also scrap in 2020 the federal subsidies to help people pay for coverage. But it would keep the regulations on what insurers have to cover and the requirement that they not turn down sick people seeking coverage or base premiums on their health status.

As a result, the pool of people buying insurance would be older and sicker, prompting insurers to increase premiums. Insurance plans could cost about 50% more right after subsidies are eliminated and could double in 10 years, the CBO estimated.

The White House and congressional Republicans have pushed back on CBO health care estimates as Congress has considered various proposals. Two White House officials penned an op- ed in The Washington Post last week warning that “the CBO’s methodology, which favors mandates over choice and competition, is fundamentally flawed.”

CBO predicts that under the repeal proposal, faced with fewer customers with higher expenses, some insurers would likely stop selling plans. About half the country could have no option in the first year after subsidies are eliminated. After 10 years, three out of four Americans might not be able to buy a plan on the individual market, according to the CBO. “That’s a true death spiral,” tweeted Larry Levitt, senior vice president at the Kaiser Family Foundation.

The bill would also end in two years the extra federal funding the ACA made available to states to expand eligibility for Medicaid to those earning slightly more than the poverty level. But unlike the bill the House passed and the Senate was unable to bring up, a repeal bill would not reduce federal support for traditional Medicaid.

Still, the rollback of Medicaid expansion is expected to significantly increase the number of people without health insurance.

CBO says that because of both the Medicaid cuts and elimination of private insurance subsidies for people who don’t get coverage through an employer, the number of people who are uninsured would rise by 32 million in 10 years.

By 2026, about 21% of Americans under age 65 could be without insurance, compared with a projected 10% if the ACA remains in place.

Republicans say the bill’s twoyear delay before the insurance subsidies and Medicaid funding are repealed would give Congress time to come up with an alternative program. But they have so far been unable to agree on what that might be. Two versions of a bill that would repeal parts of the the ACA and change some other provisions have not won enough GOP support to move to the floor over the past several weeks. Those bills would also result in millions more Americans not having insurance, according to CBO estimates.

GOP leadership still had not decided Wednesday which version of the bill would be voted on next week, but Senate Majority Leader Mitch McConnell, R- Ky., contended that it would be better to pass an overhaul than a straight repeal.