GOP's Affordable Care Act Repeal Would Grow Uninsured by 32 Million, Says CBO
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If the GOP passes legislation to repeal the Affordable Care Act without approving a replacement—and that’s a big if—the plan would have greater negative consequences for consumers than any other plan to overhaul U.S. health insurance proposed by the GOP this year.
Late Wednesday, the Congressional Budget Office (CBO) released a new analysis of a Republican plan to repeal the ACA without an immediate replacement. Under the Obamacare Repeal Reconciliation Act (ORRA), the number of uninsured would grow by 32 million and premiums would double over the next decade, according to the analysis.
By 2026, a total of 59 million people would be uninsured, compared with 28 million if the current law remained in place, leaving 21 percent of the population under 65 without health insurance, according to the CBO analysis.
At the same time, enacting the legislation would decrease the federal deficit by $473 billion in 10 years, according to the CBO score.
After a chaotic week—during which two efforts to vote on legislation to replace or repeal the ACA failed—Senate Republicans aren’t giving up. A number of Senators were meeting Wednesday night to try to salvage efforts to bring legislation to a vote, according to a Politico news report.
The Impact of A Repeal-Only Plan
Here is how the CBO says a repeal-only plan would affect insurance coverage and costs for consumers:
Millions more uninsured people. The number of people uninsured would jump by 17 million in the first year it was implemented. Within 10 years, the number of uninsured would grow by about 32 million. That’s up from the 22 million more uninsured over 10 years projected under the Senate’s earlier plan to replace the ACA, called the Better Care Reconciliation Act, according to the CBO. The repeal plan eliminates the financial subsidies lower-income people get to help pay for premiums, and it also scraps the ACA’s expansion of Medicaid, which helped 14 million people gain insurance. There would be about 23 million fewer people without individual health insurance and 19 million people without coverage under Medicaid. Those declines would be offset by an increase of about 11 million people covered by employment-based insurance.
Premiums would double. According to CBO, premiums for people who buy on the individual insurance exchanges created by the ACA would rise an average 25 percent in the first year because there would be no penalty for people who don’t buy insurance. The lack of a penalty would likely result in fewer healthy enrollees, leaving insurers to charge more to cover their higher-cost policyholders. Premiums would double in a decade and for people who would no longer get tax subsidies to help pay for premiums, the increase in net premiums would be much greater.
Parts of the U.S. would have no insurer. The prospect of the drop in coverage and the higher-than-expected health care costs for people who remain in ACA plans would drive insurance companies out of the market. According to the CBO, by 2026 a repeal would leave three quarters of the country living in areas where no insurer sells individual health insurance plans, leaving people without Medicaid or employer-insurance with literally no options.
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