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The CBO says as many as 24 million more Americans could be uninsured under 'Trumpcare'

March 14,2017 08:50

Paul Ryan House Speaker Paul Ryan, the Wisconsin Republican, focused on the projected premium decreases, while Senate Minority Leader Chuck Schumer, the New York Democrat, focused on the increase in the number of uninsured people. Jonathan ...and more »



House
Speaker Paul Ryan, the Wisconsin Republican, focused on the
projected premium decreases, while Senate Minority Leader Chuck
Schumer, the New York Democrat, focused on the increase in the
number of uninsured people.
Jonathan
Ernst/Reuters

The Congressional Budget Office
on Monday estimated that as many as 24 million more people
would be uninsured and that the federal budget deficit would
shrink by more than $300 billion over the next decade under the
Republican healthcare bill.

The findings came in a much-anticipated report detailing the
possible effects of the American Health Care Act, the GOP
leadership's plan to repeal and replace the Affordable Care Act.

The report estimated the effects of the AHCA in several areas,
including coverage totals, the federal deficit, and the cost of
premiums in the individual market.

Here's a rundown of the major findings:
14 million more people would be uninsured under the law
in 2018, increasing to 24 million by 2026.
The CBO projected that as many as 14 million more Americans
would be without health insurance under the AHCA in 2018. If
possible changes to Medicaid were to go into effect, this
number would increase to 24 million by 2026, the CBO
projected."The reductions in insurance coverage between 2018 and 2026
would stem in large part from changes in Medicaid enrollment —
because some states would discontinue their expansion of
eligibility, some states that would have expanded eligibility
in the future would choose not to do so, and per-enrollee
spending in the program would be capped," the report said. "In
2026, an estimated 52 million people would be uninsured,
compared with 28 million who would lack insurance that year
under current law."

7 million fewer people would get insurance through
their employer by 2026. The report estimated that
without the ACA's penalties associated with not having
insurance, fewer Americans would sign up for coverage through
their workplaces. Thus 2 million fewer people would choose not
to have insurance in 2020, increasing to 7 million by
2026."Part of that net reduction in employment-based coverage would
occur because fewer employees would take up the offer of such
coverage in the absence of the individual mandate penalties,"
the report said. "In addition, CBO and [the Joint Committee on
Taxation] expect that, over time, fewer employers would offer
health insurance to their workers."

The federal deficit would shrink. The CBO,
along with the JCT,
estimated that the bill would decrease the federal deficit
by $337 billion over the next 10 years. Roughly $880 billion
would be cut from outlays because of the decrease in funding
for Medicaid expansion, and $673 billion in spending would be
cut because of decreases in tax credits, but that would be
partially offset by a reduction in revenue from the mandate and
other taxes from the ACA.

The individual market would remain stable. The
report said the individual market — that is, people getting
coverage who do not have it from an employer or government
program — would remain stable if the AHCA were passed. The CBO
also said that the market under the ACA was stable as well. "In
CBO and JCT's assessment, however, the non-group market would
probably be stable in most areas under either current law or
the legislation," the report said.

Premiums in the individual market would increase in
2018 and 2019 before falling because of lower
enrollment. The report also estimated the effect on
premiums in the individual market, saying that costs would
increase in 2018 and 2019 before declining. The CBO and JCT
said that provisions of the AHCA would raise premiums for older
Americans "substantially" while shrinking them for younger
Americans."The legislation would tend to increase average premiums in the
non-group market prior to 2020 and lower average premiums
thereafter, relative to projections under current law," the
report said. "In 2018 and 2019, according to CBO and JCT's
estimates, average premiums for single policyholders in the
non-group market would be 15 percent to 20 percent higher than
under current law, mainly because the individual mandate
penalties would be eliminated, inducing fewer comparatively
healthy people to sign up."

Critics of the law had pointed to the CBO score as a way to
better understand the potential effects of the AHCA on the
federal budget and the US healthcare system.

In a statement after the release of the report, House Speaker
Paul Ryan, the Wisconsin Republican, focused on the projected
premium decreases, saying it proved that the AHCA could be
successful:

"I recognize and appreciate concerns about making sure people
have access to coverage. Under Obamacare, we have seen how
government-mandated coverage does not equal access to care, and
now the law is collapsing. Our plan is not about forcing people
to buy expensive, one-size-fits-all coverage. It is about giving
people more choices and better access to a plan they want and can
afford. When people have more choices, costs go down. That's what
this report shows. And, as we have long said, there will be a
stable transition so that no one has the rug pulled out from
under them."

On the other hand, Senate Minority Leader Chuck Schumer, the New
York Democrat, focused on the increase in the number of uninsured
people.

"The CBO's estimate makes clear that Trumpcare will cause serious
harm to millions of American families," a statement from Schumer
said. "Tens of millions will lose their coverage, and millions
more, particularly seniors, will have to pay more for healthcare.
The CBO score shows just how empty the president's promises, that
everyone will be covered and costs will go down, have been. This
should be a looming stop sign for the Republicans' repeal
effort."

The White House and proponents of the AHCA have spent much of the
past week casting doubts on the CBO score in an attempt to blunt
the widely expected blow from the report.

In a press conference last week, White House press secretary

Sean Spicer said, "If you're looking at the CBO for accuracy,
you're looking in the wrong place." Other White House surrogates,
such as National Economic Council Director Gary Cohn and Office
of Management and Budget Director Mick Mulvaney,
criticized the CBO's accuracy in interviews on Sunday.

The AHCA passed the House Energy and Commerce Committee and Ways
and Means Committee on Thursday, and it is scheduled to be
considered by the House Budget Committee on Wednesday.

SEE ALSO: The GOP is on an all-out media blitz to drum up support for its Obamacare replacement

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