14mn Americans to lose health coverage next year under GOP Obamacare replacement – CBO

The Congressional Budget Office has some bad news for Republicans pushing repeal of Obamacare. While health insurance premiums and the federal deficit are projected to drop by 2026, about 24 million Americans would also lose coverage in that time.

The CBO, a nonpartisan federal agency created by Congress over four decades ago, released its analysis of the American Health Care Act (AHCA) on Monday, leaving the Trump administration and Republican leadership in the House and Senate on the defensive.

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The legislation, introduced by House Speaker Paul Ryan (R-Wisconsin) last Monday, would replace the Affordable Care Act, former President Barack Obama’s 2010 signature health care reform bill better known as Obamacare. It faces unified opposition from Democrats, and a sizable group of more conservative Republicans have also criticized it as“Obamacare-lite.”

Under the AHCA, some 14 million people would lose health insurance in 2018, according to the CBO’s report. That is estimated to be a loss of 70 percent of whom Obamacare helped gain insurance. For comparison, 14 million people is the combined population of 13 US states or slightly more than the population of Illinois.

The figure for loss of insurance becomes even starker when the CBO projects for 2026, finding another 10 million who would no longer have coverage. The total number of uninsured would then be 52 million, rather than 28 million under Obamacare, the CBO found. That’s about 16 percent of the US population or slightly more than the total population of South Korea.

The CBO arrived at that conclusion primarily based on the roll back of Medicaid expansion and the repeal of a tax-penalty on individuals who decide not to carry insurance.

“The CBO simply has it wrong,” Secretary of Health and Human Services Tom Price told reporters Monday. The former House lawmaker stood by the AHCA, promising it would “insure more individuals than currently are insured.”

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Price noted the CBO only looked at the AHCA, not regulatory reforms, state integration grants or insurance reform being written into separate legislation. He also pointed out that under Obamacare, Americans in over 1,000 counties have just one insurance company to purchase from.

White House Press Secretary Sean Spicer said Monday that the CBO’s exact figures shouldn’t go unquestioned.

“Their projection on Obamacare was that, in 2016, it would have 24 million people on it. The actual figure is 10.4 million people ‒ less than half the number than it predicted would be insured were on it. And it’s declining,” he said.

The CBO wasn’t wholly rejected by the Republican leadership, however. One selling point was its calculation that the federal deficit would be slashed by $337 billion over the next 10 years.

That may not be enough to rally Republicans nervous about their reelection prospects in 2018. After nearly a decade of harping on Obamacare’s skyrocketing premiums, Republicans now are faced with explaining the CBO’s projection that their bill would increase premiums even more, 15 to 20 percent higher, during its first two years. Premium prices would then dip back down and by 2026 be 10 percent cheaper than Obamacare’s, but it may still be a tough sell.

Medicaid expansion under Obamacare was the major factor behind decreased premiums, but the AHCA does away with it by 2020. It allows most poor Americans to qualify for coverage originally meant for the elderly. Thirty-one states and the District of Columbia expanded Medicaid.

Democrats slammed the Republican bill on Twitter, following the CBO report publication.

Republican Congressman Thomas Massie of Kentucky also voiced opposition, while his party's leadership stayed optimistic.

AHCA has passed two committee votes and is set to be reviewed by the House Budget Committee this week before moving to the floor. Even if conservative Republicans compromise and it passes the House floor, there are also those in the Senate not facing reelection in 2018 who may feel more empowered to oppose it, including Senators Rand Paul of Kentucky, Mike Lee of Utah and Tom Cotton of Arkansas.

President Donald Trump is in favor of the AHCA, though Senator Paul has said Trump is open to negotiation. On Monday, Trump measured his enthusiasm for the replacement bill during a meeting with a group the White House deemed “Obamacare victims,” made up of entrepreneurs, physicians, and individuals who claimed their plans were dropped or their costs soared in the last six years.

“More competition, less regulation will finally bring down the cost of care,” Trump told them. “Unfortunately, it takes a while to get there because you have to let that marketplace kick in and it is going to take a little while to get there. Once it does, it is going to be a thing of beauty. I wish it didn’t take a year or two years. But that is what is going to happen.”