An astounding 24 million Americans will lose health insurance by 2026 under the House Republican leadership’s proposed Obamacare repeal, according to a Congressional Budget Office report detailing the estimated effects released Monday.
The 24-million figure comes in waves. The first is people who now have insurance under the Affordable Care Act purchased through state or federal insurance exchanges. The second wave is from lower-income people who would lose their coverage through state-administered Medicaid programs.
“In 2018, 14 million more people would be uninsured under the legislation than under current law,” the CBO’s summary said. “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 CBO report continued. “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.”
Taken together, the CBO estimates that the House Republican plan to repeal Obamacare would deprive 24 million people who now have health insurance of that coverage within a decade.
“In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” CBO said.
Before Obamacare, over 15 percent of U.S. residents were uninsured. Today, that number is less than 10 percent, the Washington-based Economic Policy Institute said. Obamacare has seen 19.2 million newly insured individuals between 2010 and 2015, including 2.8 million children.
Meanwhile, health insurance costs would rise 15-to-20 percent for many buying coverage on the open market as early as next year, CBO said, because those seeking insurance would be generally sicker as a cohort, meaning their medical costs would be more.
“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,” CBO said. “In 2018 and 2019, according to CBO and JCT’s [Joint Committee on Taxation] 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.”
The CBO report also said the House GOP bill would lead to turmoil in insurance markets as a new mix of health plans, coverage options and deductibles emerge. Younger people would mostly be seeing lower costs, but middle-aged and older people would see sizable increases.
“Although average premiums would increase prior to 2020 and decrease starting in 2020, CBO and JCT estimate that changes in premiums relative to those under current law would differ significantly for people of different ages because of a change in age-rating rules,” the report said. “Under the legislation, insurers would be allowed to generally charge five times more for older enrollees than younger ones rather than three times more as under current law, substantially reducing premiums for young adults and substantially raising premiums for older people.”
The political reaction to the CBO report is as swift as it is predictable. Republicans seeking the repeal of Obamacare at any societal cost have been saying for days that CBO’s numbers can’t be trusted—another version of the right’s fact-dismissing alternative universe. Meanwhile, opponents of Obamacare repeal are saying CBO’s analyses are even more harmful than they anticipated.
“The CBO score only confirms what was already clear, that this bill is not an honest attempt at health care reform, it is instead a tax cut for the wealthy at the expense of the health of millions of everyday Americans,” said Patriotic Millionaires, a coalition of progressive business owners whose experience includes providing employee benefits.
“It is obscene to be cutting the taxes of people like me and my husband for any reason right now,” said Molly Munger, coalition member and co-director of Advancement Project, a nationwide civil rights group. “To cut rich old people’s taxes so that you can take health care away from younger low-income families is especially crazy. We should be investing in these younger people—they are our country’s future. Don’t do me this ‘favor,’ GOP. It’s greedy and wrong at every level.”
“Because I have diabetes, am over 50, and self-employed, I was paying $5,000 a month for family policy that had a $20,000 deductible. Under the ACA, we now pay $1,400,” said Charlie Fink, director of the New Musical Development Foundation, and another coalition member. “We’re fortunate enough to absorb the hit when prices go back to what they were before, but what about the rest of America’s families, more and more of whom are in our position? A $4,000 tax credit will cover less than 10 percent of the increase in their insurance costs. This will crush them.”