WASHINGTON -- House Republican legislation to repeal and replace the Affordable Care Act would reduce federal budget deficits by $337 billion over 10 years, but leave an additional 14 million uninsured next year and 24 million more Americans uninsured over the same 10-year period, according to the Congressional Budget Office.
Republicans as well as Democrats found estimates to back their positions on the ACA in the CBO report, which was released Monday afternoon.
"This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care," said House Speaker Paul Ryan. "CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation."
The decrease of $337 billion in federal deficits would result from a $1.2 trillion decrease in direct spending, partially offset by an $883 billion reduction in revenues, CBO said. The proposed changes to Medicaid would decrease direct spending by $880 billion over the 2017 to 2026 period, it said.
But Senate Minority Leader Chuck Schumer, D-N.Y. said, "The CBO's estimate makes clear that TrumpCare will cause serious harm to millions of American families. Tens of millions will lose their coverage, and millions more, particularly seniors, will have to pay more for health care.
Reps. Richard Neal, D-Mass., and Frank Pallone, D-N.J., the top Democrats on the House Ways and Means Committee and Energy and Commerce Committee, respectively, said, "Today's CBO report now confirms what we already knew: despite promises that 'everyone would be covered' and 'no one would be worse off,' this Republican bill would rip away health insurance from 24 million Americans over the next decade and ask millions to pay more for less coverage."
The two Democrats complained that, "Republicans continue to recklessly jam this bill through Congress without so much as a single hearing on what affects their plan will have on middle-class families."
"This report also reaffirms that the Republican plan does absolutely nothing to control costs or protect consumers," the two Democrats said. "Instead, it guts Medicaid, raises costs on older Americans, and pulls billions of dollars from Medicare, all in order to pay for tax cuts for the rich."
Ryan defended the Republican plan, saying, "I recognize and appreciate concerns about making sure people have access to coverage. Under Obamacare, we have seen how government-mandated coverage does not equal access to care, and now the law is collapsing. Our plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford."
CBO said an additional 14 million people would be uninsured in 2018, mostly because of the repeal of penalties from not having insurance. By 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.
But Health and Human Services Secretary Tom Price criticized those estimates. "It's virtually impossible to have that number occur," he said about the 14 million in additional uninsured by next year. "We disagree strenuously with the report that was put out," he added.
The Republican legislation "would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter," CBO said.
"Starting in 2020, the increase in average premiums from repealing the individual mandate penalties would be more than offset by the combination of several factors that would decrease those premiums," CBO said. These would include: "grants to states from the Patient and State Stability Fund (which CBO and Joint Committee on Taxation expect to largely be used by states to limit the costs to insurers of enrollees with very high claims); the elimination of the requirement for insurers to offer plans covering certain percentages of the cost of covered benefits; and a younger mix of enrollees."
"By 2026, average premiums for single policyholders in the nongroup market under the legislation would be roughly 10 percent lower than under current law," CBO said both it and the JCT estimate.
