52M may be uninsured after ACA is repealed
Analysis by CBO predicts many will opt out of buying coverage; Health secretary disputes numbers
A Republican bill to replace Obamacare would lead to 14 million fewer Americans with health insurance by 2018 and 24 million by 2026, the non-partisan Congressional Budget Office said Monday in an analysis that could make the controversial legislation even tougher for GOP leaders to push through Congress.
Health and Human Services Secretary Tom Price said the projections of uninsured were too high and called them “just not believable.”
Most of the initial increase in uninsured people in 2018 would come from consumers deciding not to buy insurance because they would no longer have to pay a penalty for failing to do so, the CBO said in analysis done with the Joint Committee on Taxation. Others would stop buying insurance because premiums will go up over the next two years, the report said.
The bill is expected to raise the average premiums that Americans would have to pay before 2020, then lower them after that, the CBO projected. In 2018 and 2019, the average premiums for single policyholders who do not get insurance from their employers would be 15% to 20% higher than under Obamacare, the analysis said.
Starting in 2020, those premiums would begin to go down. By 2026, average premiums would be roughly 10% lower than under the Affordable Care Act, the CBO projected.
The number of uninsured Americans would rise dramatically during that same period as the replacement plan phased out Obamacare’s Medicaid expansion, the CBO said.
“In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the analysis said.
The Republican bill would reduce federal deficits by $337 billion over the 2017-2026 period, according to the CBO. The biggest savings would come from reductions in outlays for Medicaid and from the elimina-
The bill is expected to raise average premiums Americans would have to pay before 2020, then lower them, the CBO projects.
tion of the Affordable Care Act’s subsidies for low-income Americans to purchase insurance.
Administration officials said the CBO overestimated the number of people who would lose insurance and did not take into account future phases of the Republican proposal. Unlike the GOP bill under consideration, any subsequent legislation would have to attract support from Democratic senators, who are unlikely to provide it.
The CBO report came as Republican leaders in Congress scrambled to keep their fractious caucus together on the bill. Some conservatives have denounced the plan as “Obamacare lite,” arguing that it does not go far enough in scrapping the ACA and would create entitlements by replacing the law’s federal subsidies for low-income people with tax credits. Some moderate Republicans in the Senate fear their lowincome constituents would lose coverage because the legislation would phase out the expansion of Medicaid that Obamacare helped fund in many states.
Democrats are fiercely opposed to the legislation, which they said would reduce coverage and cost patients more money. They argued that the tax cuts in the bill would benefit the wealthy at the expense of middle-class and working-class families.
“The CBO score shows just how empty the president’s promises that everyone will be covered and costs will go down have been,” Senate Minority Leader Charles Schumer, D-N.Y., said in a statement. “This should be a looming stop sign for the Republicans’ repeal effort.”
House Speaker Paul Ryan, RWis., leads the push for the bill.
“This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care,” Ryan said. “CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit and make the most fundamental entitlement reform in more than a generation. These are things we are achieving in just the first of a three-pronged approach.”