The much anticipated CBO scoring of the American Health Care Act, aka “Trumpcare” is out, and among the key highlights are that while the US federal budget would be reduced by $337 billion over the 2017-2026 period, it would also mean that 14 million more would be uninsured by 2018 under the Republican ObamaCare replacement bill, with the number rising to 24 million by 2026. Furthermore, it adds that “average premiums for single policyholders in the nongroup market would be 15% to 20% higher than under current law“, i.e. prices would go up.
The key sections from the report:
- CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with 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.
- Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. 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. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.
- CBO and JCT estimate that enacting the legislation would reduce federal deficits by $337 billion over the 2017-2026 period. That total consists of $323 billion in on-budget savings and $13 billion in off-budget savings. Outlays would be reduced by $1.2 trillion over the period, and revenues would be reduced by $0.9 trillion.
- The legislation would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter, relative to projections under current law. In 2018 and 2019, according to CBO and JCT’s estimates, average premiums for single policyholders in the nongroup 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.
As the Hill notes, the long-awaited analysis from the nonpartisan congressional scorekeeper is sure to shake up the debate over the measure, which is already facing sharp criticism from conservatives and many centrist Republicans. The GOP bill repeals ObamaCare’s subsidies to buy coverage, replacing them with smaller tax credits, as well as the law’s Medicaid expansion after 2019. Both moves were expected to lead to coverage losses.
Republicans had largely expected that the CBO would show Americans losing coverage, and preemptively went on the offensive against the agency, whose director, Keith Hall, who was appointed by the GOP. White House press secretary Sean Spicer last week argued CBO was “way off” in its ObamaCare projections. “If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” he said. White House budget director Mick Mulvaney, meanwhile, argued Sunday on ABC’s “This Week” that the CBO shouldn’t even try to analyze the bill. “Sometimes we ask them to do stuff they’re not capable of doing, and estimating the impact of a bill of this size probably isn’t the best use of their time,” he said.
That said, as we have shown on numerous occasions in the past, the CBO’s predictive track record is simply abysmal.
Full report below