Making Sense of the Different CBO Healthcare Plan Scores

Donna Rosato
Updated

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Republican plans to overhaul health insurance seem to change almost every day. So it's understandable if you feel confused about how it all might affect you.

There is plenty of information. But it can quickly become overwhelming. The government agency tasked with providing answers to what it all means has been churning out reports quantifying the impact of the various GOP proposals.

The nonpartisan Congressional Budget Office (CBO) has analyzed five pieces of legislation since the start of the year to determine how many people would gain or lose coverage and how much costs would rise or fall. In just the past 24 hours, two new CBO reports came out.

The most recent was Thursday afternoon: An analysis of the latest version of the Republican Senate plan—the Better Care Reconciliation Act (BCRA)—to repeal and replace the ACA.

Number of Uninsured Americans by 2026

  • Under the Affordable Care Act (ACA): 28 million

  • Under the House plan (AHCA): 51 million, 23 million more than under the ACA

  • Under the Senate plan (BCRA): 50 million, 22 million more than under the ACA

  • Under repeal without replace (ORRA): 59 million, 32 million more than under the ACA

Percentage of Americans Under Age 65 Without Insurance by 2026

  • Under the Affordable Care Act (ACA): 10 percent

  • Under the House plan (AHCA): 18 percent

  • Under the Senate plan (BCRA): 18 percent

  • Under repeal without replace (ORRA): 21 percent  

Average Deductible in 2026

  • Under the Affordable Care Act (ACA): $5,000

  • Under the House plan (AHCA): Not available

  • Under the Senate plan (BCRA): $13,000

  • Under repeal without replace (ORRA): Not available

These figures are for standard, comparable plans analyzed by the CBO.  

Average Effect on Premiums in 2026, Compared With the ACA

  • Under the House plan (AHCA): 4 to 20 percent lower, depending on where you live

  • Under the Senate plan (BCRA): 25 percent lower

  • Under repeal without replace (ORRA): 100 percent higher

Note that the CBO says that the premiums would be slightly lower, on average, under the Senate's bill largely because the plans offered by insurance companies would be far skimpier, requiring people to pay more for their care out of their own pockets in the forms of higher co-pays for office visits and drugs and much higher co-pays. For example, as shown above, the average deductible for a benchmark plan under the Senate's plan would be $13,000, compared with less than $1,000 for that same person under the ACA.   



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