Healthcare

CBO: 24 Million Lose Coverage Under Trumpcare

Written by SK Ashby

The Congressional Budget Office (CBO) has released their score of Paul Ryan's bill to repeal and "replace" Obamacare and it's worse than expected.

The Brookings Institute estimated, based on past CBO scores, that Trumpcare would kick 15 million people off healthcare, but that was a low-ball estimate. The CBO says nearly 15 million would lose their coverage in the first year and up to 24 million people will lose coverage over the next 9 years.

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.

The CBO estimates that individual insurance premiums would increase by 15 to 20 percent over the next three years under the Ryan bill, hence the expectation that an increased number of people will go without insurance. Many people simply won't be able to afford it.

The CBO estimates that premiums will begin to decrease in 2020 after coverage requirements are repealed, but only by 10 percent relative to current costs in 2017, meaning insurers will charge almost as much for significantly worse coverage that does not cover mental health or substance abuse, among other things. Moreover, this only applies to younger Americans. While young Americans will see their premiums decline slightly after insurance is no longer required to cover anything, older Americans over the age of 50 will see their premiums skyrocket.

The CBO estimates the Ryan bill will decrease the federal deficit by just $337 billion over 10 years, which isn't very much. The reason kicking millions of people off their healthcare will not result in significantly more savings for the federal government is because the bill also includes massive tax cuts for the rich.