By Alan Fram and Ricardo Alonso-Zaldivar / Associated Press
WASHINGTON — Fourteen million Americans would lose coverage next year under House Republican legislation remaking the nation’s health care system, and that figure would grow to 24 million by 2026, Congress’ nonpartisan budget analysts projected Monday. The figures dealt a blow to a GOP drive already under fire from both parties and large segments of the medical industry.
The report by the Congressional Budget Office flies in the face of President Donald Trump’s aim of “insurance for everybody,” and he has been assailing the credibility of the CBO in advance of the release. Administration officials quickly took strong issue with it.
It also undercuts a central argument that he and other Republicans have cited for swiftly rolling back former President Barack Obama’s health care overhaul: that the health insurance markets created under the 2010 law are unstable and about to implode. The congressional experts said that largely would not be the case and the market for individual health insurance policies “would probably be stable in most areas either under current law or the (GOP) legislation.”
Even though Republican tax credits would be less generous than those under “Obamacare,” the combination of those credits and other changes to lower premiums would attract enough healthy people to stabilize markets under the new plan, the report said.
In a talking point embraced by Republicans, the budget office concluded that the GOP measure would reduce federal deficits by $337 billion over the coming decade. That’s largely because the legislation would cut Medicaid and eliminate subsidies Obama’s law provides millions of people who buy coverage.
The budget office attributed the projected increases in uninsured Americans to the GOP bill’s elimination of tax penalties for people who don’t buy insurance, its changes in federal subsidies for people who buy policies and its curbing of Medicaid, the federal-state program that helps low-income people buy coverage.
By 2026, the office estimated, a total of 52 million people would lack insurance — including 28 million already expected to lack coverage under Obama’s statute.
While long anticipated, the budget office’s adverse estimates provide a detailed, credible appraisal of the Republican effort by an agency with a four-decade history of even-handedness that’s currently headed by a GOP appointee. It feeds ammunition to Democrats and to some Republicans who’ve argued the GOP measure would toss millions of voters off coverage they gained under Obama’s overhaul.
Trump said in an address to Congress last month that he wants to “expand choice, increase access, lower costs and at the same time provide better health care,” a less expansive coverage goal that has been embraced by House Speaker Paul Ryan, R-Wis., and other authors of the GOP legislation.
Backed by Trump, House Republican leaders say coverage statistics are misleading because rising out-of-pocket costs make the policies many gained under Obama’s statute unaffordable.
The budget office found that average premiums for individuals would rise in 2018 and 2019 by 15 percent to 20 percent compared to current law, because Republicans would eliminate the penalties designed to induce people to buy insurance coverage.
But beginning in 2020, premiums would begin to fall in comparison to current law, and by 2026 average premiums for people buying individual coverage would be roughly 10 percent lower than current law.
However, premiums would vary significantly for people of different ages because of a change Republicans would make allowing old people to be charged more for insurance coverage, compared to young people, than allowed under Obamacare.
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