14 million would lose coverage under GOP repeal legislation, CBO says

The Congressional Budget Office estimates that 14 million people would lose health coverage in 2018 under the Republican legislation to repeal and replace the Affordable Care Act.

Additionally, the number of uninsured would rise to 21 million two years later, and then to 24 million by 2026, according to estimates.

In total, 52 million people would lack health insurance in 2026 under the Republican bill, compared with 28 million under the current law.

Premiums for single-policy holders in the individual market would jump by 15 to 20 percent in 2018 and 2019 under the Republican legislation, the Congressional Budget Office estimates. That premium hike would come mainly because of the bill’s elimination of the individual mandate, which requires most Americans to have coverage or face a tax penalty.

The findings, although not surprising, provide yet another political hurdle for House Speaker Paul Ryan’s controversial plan, which is facing stiff opposition from hospitals, doctors, seniors and patient advocacy groups.

The American Health Care Act, as his bill is called, struggles with lukewarm support from moderate Republicans who fear it harms seniors and the poor, and strong resistance from the party’s conservative wing who say it’s too much like Obamacare.

Republicans have been girding for the report since last week, trying to raise doubts by casting aspersions on the accuracy and significance of the Congressional Budget Office’s work.

White House Press Secretary Sean Spicer, OMB director Mick Mulvaney and HHS Secretary Tom Price all have taken swipes at CBO’s enrollment projections for the health insurance marketplace.

In 2015, about 9 million people enrolled on state and federal marketplaces, far below the 13 million the Congressional Budget Office had originally projected.

The CBO’s original enrollment estimates for the ACA in March 2010 projected that 21 million people would obtain marketplace coverage by 2016. But only 11.5 million people had signed up for coverage at the end of 2016, according to government figures.

The CBO also predicted in 2010 that 30 million people would gain coverage by 2016 because of the health law. The CBO lowered its estimate to 22 million in March 2016.

That CBO projection – off by 8 million people – did not account, however, for the U.S. Supreme Court decision that gave states the right to opt out of the Affordable Care Act’s Medicaid expansion. Many states did so, which slowed coverage gains under Obamacare.

After Ryan’s bill passed two key House committees last week, ?????? suggest the legislation could run into problems in the House Budget Committee, which will take up the measure later this week.

The bill would repeal Obamacare’s individual covearge mandate and would replace the Affordable Care Act’s income-based tax credits with smaller amounts based on age. The legislation also phases out enhanced funding for 11 million newly eligible Medicaid recipients.

The Republican bill would be largely paid for by cuts to the Medicaid program, which the bill would move from an open-ended entitlement program to one with capped funding based on the number of enrollees. The shift will cost states an estimated $370 billion in federal Medicaid funding

Even before the Congressional Budget Office’s score came out, independent analyses in the past two weeks showed the bill could bring high costs to the Treasury and big hits to the nation’s newly insured.

S & P Global predicted the Republican bill would cause two million to four million people to lose their individual health coverage and another four million to six million Medicaid recipients to lose coverage from 2020 to 2024.

The non-partisan Brookings Institution think tank expected the CBO to find at least 15 million people will lose their coverage under the Republican measure over its first decade.

The Joint Committee on Taxation estimates that repealing the Affordable Care Act’s taxes would cost roughly $600 billion through 2026 and nearly $700 billion through 2027.

More than half of the tax-cut benefits would flow to the wealthy. People earning more than $1 million a year would see average annual tax cuts of $57,570 in 2025, according to estimates by the Urban-Brookings Tax Policy Center.

About 9 million people enrolled on state and federal marketplaces in 2015, far below the 13 million the Congressional Budget Office had projected.

Since 1975, CBO has produced independent analyses of budgetary and economic issues to support the Congressional budget process. Each year, the agency’s economists and budget analysts produce dozens of reports and hundreds of cost estimates for proposed legislation.

CBO is strictly nonpartisan; conducts objective, impartial analysis; and hires its employees solely on the basis of professional competence without regard to political affiliation. CBO does not make policy recommendations, and each report and cost estimate summarizes the methodology underlying the analysis. Learn more about CBO’s commitment to objectivity and transparency.

This story was originally published March 13, 2017 at 4:24 PM with the headline "14 million would lose coverage under GOP repeal legislation, CBO says."