No, the Republican Healthcare Bill Would Not Cause 23 Million People to “Lose” Insurance

As Katie reported last evening, the latest Congressional Budget Office score of the House-passed American Health Care Act contains good news and bad news for the GOP. On the bright side, it appears that its central fiscal outcome complies with reconciliation rules, which would allow the process to move forward without a complicated tweak-and-do-over vote in the House. The nonpartisan scorekeeper also found that individual market premiums “would decline on average,” and would reduce the federal deficit by $119 billion. On the other hand, media outlets are running with false headlines like these:

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Key Takeaways From CBO Score of the Republican Health Care Bill

The Congressional Budget Office (CBO) updated their score of the House-passed American Health Care Act (AHCA) this week, prior to its being sent over to the Senate.

This budgetary analysis projects that if passed into law, the AHCA would reduce the number of insured by 23 million, but would decrease the deficit by $119 billion while also reducing federal outlays by $1.1 trillion and federal revenue by $992 billion.

While the score is roughly similar to the score from the original version of the AHCA released on March 23, several modifications to the law occurred since then and were not reflected in earlier estimates.

The new CBO score addresses the effect of allowing states to waive the Affordable Care Act essential health benefit and community rating requirements on premiums in particular.

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CBO’s 23 Million Uninsured Under GOP’ Not What It Seems

Democrats use report from agency with flawed record to slam health plan

Democrats and much of the mainstream news media Wednesday poured cold water on the the House Republicans’ American Health Care Act, citing a report from the Congressional Budget Office that the legislation to begin dismantling Obamacare would result in 23 million uninsured in the next 10 years.

“The CBO was wrong when they analyzed Obamacare’s effect on cost and coverage, and they are wrong again,” Health and Human Services Secretary Tom Price countered in a statement.

“In reality, Americans are paying more for fewer health-care choices because of Obamacare, and that’s why the Trump administration is committed to reforming health care.”

House Republicans passed the bill three weeks ago without waiting for the CBO to release a score for the legislation. It replaced an earlier version of the AHCA that the CBO had said would result in 24 million being without insurance.

But the figures of those left without insurance, at least as widely reported, is misleading. It includes nine million already without coverage under Obamacare. The remaining 14 million are made up of those who could potentially lose coverage under the new bill, plus those who take advantage of the AHCA eliminating the mandate to purchase coverage. For the latter group, being allowed to remain uninsured is a positive option. The requirement to be covered under Obamacare or pay a penalty has been an unpopular feature of the present health law.

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CBO: Obamacare Repeal Will Cut Deficit By $119 Billion, Leave 23 Million More Uninsured

The CBO has finally scored the House-passed healthcare bill, H.R.1628 (which as a reminder remains DOA in the Senate), and finds modest improvement relative to its last scoring of the proposed Healthcare bill as of March 23. Here are the apples to apples comparisons with the last proposed version of the bill:

  • Under the House-passed Bill, the US budget deficit would be reduced by $119 billion between 2017 and 2026. This is $31 billion less than the proposed March bill, which would have lowered the deficit by $150 billion.
  • Offsetting the smaller benefit on the deficit, the CBO found that the number of Americans expected to lose their health coverage would rise to 23 million in 2026, which is 1 million fewer than the 24 million forecast in March, or roughly $31 billion in spending over 10 years to provide 1 million Americans with insurance over the same time period.
  • The CBO concludes that in 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law. Under the last CBO estimate, the number of Americans wihtout insurance in 2026 was 52 million of Americans under 65, so an improvement of 1 million as expected.

Below is the “bridge” of the budget deficit reduction from the CBO:

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Don’t Let Insurers Hold Americans Hostage For Cost-Sharing Payments

While insurers claim ‘uncertainty’ compels them to threaten pulling from exchanges or higher premiums, in reality the cause is their gross incompetence and crass politics.

The coming weeks will see U.S. health insurance companies attempt to preserve what amounts to an extortion racket. Already, some carriers have claimed they will either exit the Obamacare exchanges entirely in 2018, or submit dramatically higher premium increases for next year, if Congress does not fund payments to insurers for cost-sharing reductions. While insurers claim “uncertainty” compels them to make these business changes, in reality their roots are the companies’ gross incompetence and crass politics.

While Obamacare requires insurers to lower certain low-income individuals’ deductibles and co-payments, and directs the executive agencies to reimburse insurers for those cost-sharing reductions, it nowhere gives the administration an explicit appropriation to do so. The Obama administration made payments to insurers without an explicit appropriation from Congress, and was slapped with a federal lawsuit by the House of Representatives for it.

Insurers claim they need certainty regarding the payments before committing to the exchanges for 2018. But insurers never had a guarantee about the payments continuing in 2017. I noted in a blog post last May that the new president could easily cut off the subsidy payments unilaterally. The week after I published my post, Judge Rosemary Collyer ruled in favor of the House of Representatives in its lawsuit. Although Collyer stayed her order pending an appeal, she ruled that the Obama administration needed an explicit appropriation from Congress to continue paying cost-sharing reductions to insurers.

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Democrats Go On Offense On Obamacare Rate Hikes

Democrats have switched from defense to offense, going on the attack as insurers announce major increases in their premiums for Obamacare next year.

The party is blaming proposed hikes of up to 50 percent for some 2018 Obamacare plans on the Trump administration’s efforts to create uncertainty in the individual market, which includes Obamacare’s exchanges. However, some insurance plans have noted other factors in the proposed increases, including Obamacare’s insurer tax.

Nevertheless, Democrats are highlighting the increases to show that Trump is seeking to torpedo the markets to promote his efforts to replace Obamacare….continue reading

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