3 Takeaways from the New CBO Score of the Republican Healthcare Plan
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A much-anticipated analysis of GOP plans to overhaul the Affordable Care Act (ACA) makes it clear that health insurance could change drastically for most people, especially older ones, the sick, and the poor. And the precise effect will likely differ depending on where you live.
The analysis of the House Republican’s American Health Care Act (AHCA) comes from the nonpartisan Congressional Budget Office. The new CBO report was needed because its previous calculations, in March, were done before amendments were tacked onto the bill that the House passed in early May.
House Speaker Paul Ryan said in a statement, “This CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit.”
And indeed the CBO report does project that the AHCA would save the government about $119 billion by 2026 and over time slightly lower average premiums.
But it also makes it clear those savings would come at the expense of 23 million people losing insurance than if the Affordable Care Act remained in place. And premiums would decline, according to the CBO report, “in part because the insurance, on average, would pay for a smaller proportion of health care costs."
In other words, because insurance would be skimpier, and people would have to pay for more of their healthcare out of their own pocket, says Betsy Imholz, director of special projects for Consumers Union, the policy and mobilization arm of Consumer Reports. “Those who are able to find coverage will see rising out-of-pocket costs from plans that may offer little, if any, meaningful coverage," she says.
Moreover, those changes will likely vary substantially depending on your age, your health, and where you live. In some states, the CBO report says that people with pre-existing health problems may not be able to buy insurance at all.
The 3 Takeaways
1. The number of people without insurance would nearly double.
The CBO estimates that 23 million fewer people will have health insurance by 2026 under the latest version of the AHCA, slightly less than the 24 million that the CBO first projected.
The CBO chalks up the difference mainly to fewer people losing employer health insurance. Employers would be less likely to drop coverage if they knew their workers wouldn't get adequate coverage in the individual insurance market and would choose to offer insurance to attract workers, says Sara Collins, vice president of health care coverage and access at the Commonwealth Fund, a nonpartisan foundation that does independent research on health and social issues.
3. People with pre-existing conditions could pay a lot more depending on where they live.
The AHCA also allows states to apply for waivers that would enable insurers to charge people with pre-existing health conditions higher rates if they have a break in health insurance coverage.
The CBO projects that about one-sixth of people—about 54 million Americans—live in states that would likely choose to waive both essential health benefit requirements and protections for people with pre-existing health conditions. In those states premiums would vary significantly based on your health and the types of benefits provided, leaving less healthy people with extremely high premiums.
In those states, the CBO's forecast is grim: "People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive nongroup health insurance at premiums comparable to those under current law, if they could purchase it at all."
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