Affordable Care Act revision would reduce insured numbers by 24 million, CBO projects (Washington Post link): House Republicans’ proposal to rewrite federal health-care law would more than reverse the gains the Affordable Care Act has made in the number of Americans with health insurance, while curbing the federal deficit, according to a widely anticipated forecast by congressional analysts.
The analysis, released late Monday afternoon by the Congressional Budget Office, predicts that 24 million fewer people would have coverage a decade from now than if the Affordable Care Act remains intact, nearly doubling the share of Americans who are uninsured from 10 percent to 19 percent. The office projects the number of uninsured people would jump 14 million after the first year.
But the GOP legislation, which has been speeding through House committees since it was introduced a week ago, would lower the deficit by $337 billion during that time, primarily by lessening spending on Medicaid and government aid for people buying health plans on their own.
The report predicted that premiums would be 15 percent to 20 percent higher in the first year compared with those under the Affordable Care Act but 10 percent lower on average after 2026. By and large, older Americans would pay “substantially” more and younger Americans less.
The 37-page report provides the most tangible evidence to date of the human and fiscal impact of the House GOP’s American Health Care Act. It also undermines President Trump’s pledge that no Americans would lose coverage under a Republican remake of the Affordable Care Act, which was enacted by a Democratic Congress in 2010.
Consider Paul Ryan's feel-good meeting with Senate Republicans on Tuesday. The House speaker trekked across the Capitol to reassure senators that lawmakers are making more progress toward repealing the health care law than the media are reporting.
But not everyone was buying it. Sen. Rand Paul (R-Ky.) left before it was over, having heard enough of a conversation that he says centers around keeping Obamacare's Medicaid expansion intact and creating tax credits that he called a "new entitlement program," though a Republican in the room rebutted the notion that the topic of Medicaid expansion came up in the Tuesday meeting with Ryan.
"I hear things that are unacceptable to me," Paul said in an interview afterward. "If they don't seem to care what conservatives think about complete repeal of Obamacare, they're going to be shocked when they count the votes."
It may take a direct intervention from Trump to get the party's warring factions in line.
At first, Trump's call to repeal and replace simultaneously disrupted the party—which at the time was intent on repealing now and figuring out the rest later. But eventually, they came around to Trump's apparent position and stopped sniping for a few weeks. Now that the party is back in disarray, no one is quite sure what Trump wants. They're straining to read the tea leaves from a president whose latest statements about Obamacare have confused the timeline and offered no clear direction.
The hard-liners in the Freedom Caucus are using this confusion to become even more entrenched. Trump has other things to think about, clearly, and expects Ryan and McConnell (who has faded into the wallpaper on this one) to figure it out. Meanwhile, Tom Price and the Trump regime team are putting the wheels in motion to sabotage the law, destroying it from the inside if they can.
At some point, and it really should be sooner rather than later to save everyone's asses, the Republicans need to recognize that they will own the destruction of our health care. That it will be Trumpcare and he and they will be blamed for it all. That what they need to do is take a few deep breaths and figure the few things Democrats would like to tweak, too. Do those, call it "fixed" and declare victory. That would be best for everyone involved, especially the people who have health insurance and enjoy it.
But the maniacs aren't going to let that happen, so we all have to suffer.
House Speaker Paul Ryan pressed that point in a series of appearances Monday night, suggesting that the budget office had found that the House bill would increase choice and competition and lead to lower prices. The Senate majority leader, Mitch McConnell, issued a statement saying, “The Congressional Budget Office agrees that the American Health Care Act will ultimately lower premiums and increase access to care.”
But the way the bill achieves those lower average premiums has little to do with increased choice and competition. It depends, rather, on penalizing older patients and rewarding younger ones. According to the C.B.O. report, the bill would make health insurance so unaffordable for many older Americans that they would simply leave the market and join the ranks of the uninsured.