By Harris Meyer | May 24, 2017
Here's what the CBO reported on the cost and coverage
impact of the House Republicans' bill to repeal and replace the Affordable Care
Act.
(All projections are in comparison to current law)
(All projections are in comparison to current law)
1.
Reduce the cumulative
federal deficit by $119 billion by 2026; the prior version of the AHCA would
have cut the deficit by $150 billion.
2.
Increase the number of
uninsured by 14 million in 2018, growing to 23 million by 2026; the previous
bill would have raised the number of uninsured by 24 million in 2026.
3.
Result in a total of 51
million uninsured in 2026, compared with 28 million under current law.
4.
Significantly increase the
number of uninsured among people ages 50 to 64 with income under 200% of
poverty.
5.
Lower federal Medicaid
spending by $834 billion over 10 years.
6.
Reduce the number of people
on Medicaid by 14 million in 2026, a 17% decrease.
7.
Save $290 billion over 10
years by replacing the ACA's premium and cost-sharing subsidies with less
generous age-based premium tax credits, reducing spending from $665 billion to
$375 billion.
8.
Increase Medicare
disproportionate-share payments to hospitals by $43 billion over 10 years due
to a jump in uninsured patients.
9.
Prompt states where half
the U.S. population lives to seek waivers from the ACA's individual insurance
market rules on minimum essential health benefits, use of pre-existing
conditions for setting premiums and guaranteed issue.
10. Reduce
individual-market premiums in states that did not seek waivers by about 4% in
2026, mainly because more younger, healthier people and fewer older, sicker
people would buy coverage.
11. Create individual-market instability in states seeking fuller waivers where one-sixth of the U.S. population lives; premiums for people seeking to buy comprehensive plans would become unaffordable.
12. Reduce individual-market premiums overall while sharply increasing premiums for older, low-income people.
13. Substantially increase out-of-pocket costs for people in states that waived ACA requirements on essential health benefits, particularly for maternity, mental health and substance abuse services.
14. Prompt a few million people to use premium tax credits to buy plans that don't cover major medical costs.
15. Result in 4 million more people in employer-based health plans by 2026, mainly because employers would see the individual market as a less desirable option for their workers.
11. Create individual-market instability in states seeking fuller waivers where one-sixth of the U.S. population lives; premiums for people seeking to buy comprehensive plans would become unaffordable.
12. Reduce individual-market premiums overall while sharply increasing premiums for older, low-income people.
13. Substantially increase out-of-pocket costs for people in states that waived ACA requirements on essential health benefits, particularly for maternity, mental health and substance abuse services.
14. Prompt a few million people to use premium tax credits to buy plans that don't cover major medical costs.
15. Result in 4 million more people in employer-based health plans by 2026, mainly because employers would see the individual market as a less desirable option for their workers.
Harris
Meyer is a senior reporter providing news and analysis on a broad range of
healthcare topics. He served as managing editor of Modern Healthcare from 2013
to 2015. His more than three decades of journalism experience includes
freelance reporting for Health Affairs, Kaiser Health News and other
publications; law editor at the Daily Business Review in Miami; staff writer at
the New Times alternative weekly in Fort Lauderdale, Fla.; senior writer at
Hospitals & Health Networks; national correspondent at American Medical
News; and health unit researcher at WMAQ-TV News in Chicago. A graduate of
Northwestern University, Meyer won the 2000 Gerald Loeb Award for Distinguished
Business and Financial Journalism.
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