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Republicans’ Health Bill Would Leave 23 Million More Uninsured: Congressional Budget Office

The nonpartisan Congressional Budget Office estimates that the GOP’s Obamacare repeal-and-replace bill would increase the number of uninsured and reduce the deficit.

Speaker of the House Paul Ryan holds up a copy of the American Health Care Act during a news conference with House Majority Leader Kevin McCarthy R-Calif., (left) and House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) outside Ryan’s office in the U.S. Capitol on March 7.

The revised Republican bill to repeal and replace the Affordable Care Act will leave 23 million more people uninsured over the next decade than if that act, also known as Obamacare, were to remain in place. The GOP bill would also reduce the deficit by $119 billion.

That’s what the nonpartisan Congressional Budget Office reported on Wednesday in its latest score of the American Health Care Act. The CBO’s assessment shows that premiums could fall for some Americans, but it raises potential concerns about the bill. The agency reports that the bill could destabilize individual insurance markets in some states, leaving unhealthy Americans unable to buy insurance. The CBO also notes that the AHCA could mean some Americans would buy coverage that doesn’t cover “major medical risks.” Because of those policies’ skimpy coverage, the CBO doesn’t count those people as insured in this report.

The act could make obtaining healthcare coverage prohibitively expensive for some sicker Americans, the CBO found.

That’s because under the AHCA, states could get waivers exempting them from some Obamacare provisions, including what are called “essential health benefits” — a list of basics like mental health and prescription drugs that the Affordable Care Act required plans to cover. States could also get waivers that allow insurers to charge more for people with preexisting conditions.

One challenge the CBO faced in creating these estimates was figuring out how many states would get those waivers. In the end, they estimated that around one-sixth of the population lives in states that would seek both of those waivers. In those states, less healthy Americans could face “extremely high premiums,” the report said.

“Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly,” the CBO wrote.

The fate of the bill rests in part on this score, as House Republicans passed their most recent version of the bill without waiting for the CBO to report the bill’s estimated price tag. Three weeks after passing the bill, however, they have not sent the bill on to the Senate yet, because budget rules dictate that if its deficit savings did not reach $2 billion (and that $2 billion had to come from particular spending categories), the bill would be dead upon arrival in the upper chamber.

The deficit reduction in the latest version of the bill represents a decline from previous versions. When the CBO first scored the AHCA, it said the plan would save $337 billion over 10 years. Later revisions reduced those savings to $150 billion.

By far the biggest savings would come from Medicaid, which serves low-income Americans. That program would face $884 billion in cuts. Cutbacks in subsidies for individual health insurance would likewise help cut $276 billion. But those are offset in large part by bigger costs, including the repeal of many of Obamacare’s taxes.

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