Health Politics

Congressional Budget Office Releases Analysis of ACA Repeal

On Monday, the non-partisan Congressional Budget Office (CBO) released its assessment of House Republican’s replacement for the Affordable Care Act.

The CBO found that, if passed, the American Health Care Act would increase the number of uninsured Americans by 14 million in 2018, largely because healthier people in the individual marketplace will opt not to purchase health insurance after the tax penalty is removed and increases in tax deductibles will make the out-of-pocket cost an unrealistic expense. The reconciliation bill initiates tax credits based on age instead of income bracket, repeals the cost sharing subsidies that made insurance in the ACA marketplace more affordable, and ends all of the Obama era taxes that were instituted to supplement the costs of those subsidies.

After that initial drop, the CBO estimates that the number of uninsured would continue to increase, largely because of the people who would be removed or barred from Medicaid after block grant funding is instituted by 2020. The CBO says this block grant funding would likely cut the amount spent on Medicaid by $880 billion over the next decade, one of the major reasons the bill could decrease the federal deficit.

By 2026, 52 million Americans would be without health insurance, an additional 24 million than the CBO projected would have coverage if the Affordable Care Act were to stay.

In addition, the CBO says that barring Planned Parenthood from receiving Medicaid reimbursements would mean 15 percent of their patients in underserved communities going without reproductive healthcare services resulting in thousands of additional births. Medicaid makes up more than 40 percent of Planned Parenthood’s annual funding and currently covers the costs of approximately 45 percent of births in the United States.

The bill was already experiencing widespread skepticism by many healthcare providers, some Republicans, and every Democrat on the hill.  Senator Susan Collins (R-ME) called the CBO report a “cause for alarm” and encouraged the House to “slow down and reconsider certain provisions of the bill.”

The President and some other Republicans have been quick to point out that the CBO did not perfectly estimate the number of Americans who would be insured by 2016 under the Affordable Care Act, but the CBO was only off on ACA numbers by around 20 percent. As Senator Lindsay Graham (R-SC) said, “If they’re half right, that’d still be a lot of people who are uninsured.”

The bill has already been approved along party lines by the House Energy and Commerce Committee and the House Ways and Means Committee, and now awaits a vote before the House Budget Committee.

Media Resources: New York Times 3/13/17; Vox 3/13/17; Huffington Post 3/14/17; Washington Post 3/14/17; Feminist Majority Foundation 3/13/17

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