GOP Health Care Bill Could Leave 24M More Without Coverage By 2026, CBO Says
The Congressional Budget Office has released a report on the potential impact of the House GOP health care bill. It estimates that the bill would reduce the federal deficit by $337 billion between 2017 and 2026. It also estimates that compared with current law, 14 million more people would be uninsured by 2018, and 24 million more would be uninsured by 2026.
Just over 28 million Americans were uninsured in the first half of 2016, according to the latest data from the Census Bureau. The CBO estimates that in 2026, there would likewise be 28 million uninsured Americans if the current healthcare laws remained in place. However, 52 million would be uninsured under the Republican repeal and replace plan thus far, also known as the American Health Care Act.
Much of the initial spike in uninsured Americans would come from repealing the individual mandate.
"Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums," the CBO wrote.
But overall, a big chunk of that increase in the uninsured comes from Medicaid, as the Republican bill rolls back the Affordable Care Act's Medicaid expansion. In 2026, 14 million fewer people would be enrolled in Medicaid under the GOP healthcare bill, accounting for half the total increase in uninsured.
In addition, CBO estimates that the Republican bill would reduce the number of employers offering health insurance, in part because the AHCA repeals the employer mandate to provide insurance. In addition, the CBO notes that the GOP plan's tax credits (only available to people who aren't offered insurance at their jobs) would be available to more people than under Obamacare. That could inspire some people to look outside of their jobs for coverage.
That all covers the number of people who would be insured under the AHCA, but the type of people covered would also shift: namely, the people in the individual market would skew younger than they would otherwise. That's because younger people would have comparatively more financial help, the CBO explained:
"Under the legislation, premiums for older people could be five times larger than those for younger people in many states, but the size of the tax credits for older people would only be twice the size of the credits for younger people," they wrote.
While the number of uninsured Americans would immediately climb, the trajectory for premiums is more complicated. In the near future, average premiums for single people buying insurance in the individual market would be up to 20 percent higher than they would be under Obamacare.
However, those premiums would eventually settle below where they would be under Obamacare. By 2026, those same premiums would be 10 percent below where they would be under the Affordable Care Act.
Importantly, that doesn't mean that everyone's premiums would fall. The GOP's bill expands how much more insurers can charge older people than younger people. Under the AHCA, older Americans could be charged five times more than younger people, up from three times under current law.
That means premiums would be "substantially" smaller for younger insurance-buyers and "substantially" bigger for older Americans, the CBO wrote.
The Republicans' new plan would reduct the deficit by just under $34 billion a year, on average, over the next 10 years. For fiscal year 2016, the total federal budget deficit was $587 billion.
The AHCA is just the first part of the Republicans' plan to repeal and replace the Affordable Care Act, also known as Obamacare. The bill, written as part of the budget reconciliation process, can only make fiscal-related changes. Part two of the GOP's process as described by House Speaker Paul Ryan will include deregulation. Part three will include changes to the law that could not be made in the reconciliation bill.
President Trump has not yet responded directly on Twitter to the CBO's report. However, he did tweet shortly after the report's release, drawing attention to a report that the Obama administration spent $77 million on promoting Obamacare in 2016.