Roughly 23 million more people would be uninsured over a decade if the House-passed Republican Obamacare repeal bill becomes law, according to a long-awaited CBO analysis that could complicate GOP hopes of getting a companion measure through the Senate.
That’s nearly identical to the coverage losses that CBO forecast for an earlier version of the bill — despite the addition of new provisions and billions in funding aimed at keeping more people insured.
The nonpartisan score-keeping office also forecasts the GOP plan would cut the deficit by $119 billion over a decade, primarily because of its cuts to Medicaid and private insurance subsidies. That easily clears the $2 billion of minimum projected savings the bill needed to be taken up by the Senate.
But the prediction of coverage losses is expected to add more fuel to Democratic arguments that the people who signed up for coverage under Obamacare would be much worse off under the GOP bill. The CBO in March projected that an earlier version of the legislation would leave roughly 24 million more people uninsured over a decade, prompting a backlash that forced GOP leaders to abandon a planned vote. That plan was projected to cut the deficit by $150 billion over a decade.
The nonpartisan office also forecasts the GOP plan would cut the deficit by $119 billion over a decade, primarily because of its cuts to Medicaid and private insurance subsidies.
Six weeks later, House Republicans narrowly advanced a revised version of their American Health Care Act without waiting for a new CBO score.
The current Republican bill to repeal and replace major parts of Obamacare will lead to 23 million more Americans not having health insurance coverage by 2026 if it becomes law, the Congressional Budget Office projected Wednesday.
That is only 1 million fewer uninsured people than had been projected for an earlier version of the GOP bill.
Most of the coverage losses still would occur next year, when 14 million more people would become uninsured than would otherwise be if Obamacare remained in place, CBO said in its new report.
However, starting in 2020, premiums in different states would be affected in different ways by the bill, because of an amendment that would allow states to obtain waivers from current Obamacare rules mandating the design of health plans, and barring insurers from charging less-healthy people higher prices, CBO said.
And the non-partisan CBO said that the federal budget deficit would decrease by $119 billion over the next decade if the American Health Care Act is signed into law. That is $32 billion less in net savings projected to be achieved under an earlier version of the bill.
But the latest version still achieves enough deficit savings to avoid the House of Representatives having to recast the legislation, and vote on it a second time to ensure that it qualifies for Senate consideration.
The CBO’s report comes three weeks after the House of Representatives, by a margin of just a single vote, passed the AHCA with strong encouragement from President Donald Trump and his administration.
The House conducted that vote May 4 without first having the CBO analyze the revised bill, as is the norm, and as CBO had done for prior versions of the legislation in the weeks leading up to the vote.
The new report reflects the projected effects of several amendments that were made to the bill before that vote, including the so-called MacArthur Amendment that opens the door to “skimpier” health plans and higher charges for people with pre-existing health conditions in some states.
Before Wednesday’s analysis, the most-recent CBO report on the American Health Care Act said that an earlier version of the bill would lead to 24 million more people being uninsured by 2026 than would be the case if Obamacare stayed the law in current form.
The coverage losses result from the proposed elimination of the Obamacare rule that currently requires most Americans to have some form of health coverage or pay a fine, as well as changes to the nation’s Medicaid program.
The CBO in that same report issued March 23 also had projected that average premiums for individual health plans would be 15 to 20 percent higher by next year and in 2019 than they would be if Obamacare remained in place.
However, CBO also estimated that by 2026, individual premiums under AHCA would be 10 percent lower than Obamacare premiums are expected to be by that year.
The prior CBO report projected that the Republican bill would reduce federal budget deficits by $150 billion over the period of 2017 through 2026.
A group of Republican senators have been meeting regularly to discuss how to craft health-care legislation that theoretically could include some or most of the AHCA.
But Sen. Mike Lee, R-Utah, a member of that group, told Fox News on Wednesday, “We all understand that the House bill has to be essentially rewritten.“
“There is not going to be a whole lot about the Senate bill that looks identical to the House bill,” Lee told Fox.
But even as Lee and his GOP colleagues continue their meetings, there is skepticism that Republicans will be able to pass a major bill that repeals and replaces much of Obamacare, despite holding control of both the House and the Senate.
Within their own caucuses, GOP leaders in both chambers of Congress face members who are worried about political fallout from a bill that could lead both to very large increases in the numbers of uninsured Americans, as well as to even higher price hikes for health plans that would be seen under Obamacare.
Senator Majority Leader Mitch McConnell, the Republican from Kentucky, told Reuters in an interview published Wednesday that “I don’t know how we get to 50 [votes] at the moment. But that’s the goal.”
Republicans, who hold 52 seats in the Senate, would need 50 of their members to pass any health-care reform bill, assuming that no Democrats vote for it, and that Vice President Mike Pence would break any tie.
The AHCA has been broadly unpopular among the general public. But it has been pushed by leading Republicans, including Trump, who have noted that many of their supporters have demanded that Obamacare be repealed.
Those Republicans also argue that Obamacare is failing because premiums have risen sharply, and because of the lack of competition among insurers in large parts of the United States.
Defenders of Obamacare say the law could be improved, but is not failing, and argue that it has led to historic reductions in the number of uninsured Americans, as well as to protections for people with health conditions.
The bill would make multiple, major changes to Obamacare, particularly in the way the federal government subsidizes insurance coverage for millions of Americans.
The AHCA would increase the amount of federal subsidies to young people to help them pay for their individual plan health insurance premiums, but it would reduce the amount for older adults. It also would allow those subsidies to buy health plans outside of government-run Obamacare marketplaces.
The bill also would allow insurers to charge older adults premiums that are up to five times higher than what they charge younger adults. Obamacare, in contrast, imposes a 3:1 ratio for premiums.
The AHCA would impose a premium penalty on people who do not maintain continuous health coverage.
And the bill would establish funding for states that can be used for “high-risk” individuals, or other purposes.