Thirty-two million more people people will be uninsured by 2026, compared to current law, if the GOP repeal-and-delay legislation the Senate may vote on next week becomes law, the Congressional Budget Office said Wednesday.
The legislation, which was posted shortly before the CBO released its score, tracks closely with a bill that Congress passed and then-President Barack Obama vetoed in early 2016.
The CBO report also said that premiums would double by 2026 under the Senate legislation, which eliminates the Affordable Care Act’s taxes, insurance subsidies and Medicaid expansion, but keeps its regulatory regime in place.
The repeal of the subsidies and expansion would go into effect in 2020, while the elimination of individual mandate would take place right away.
The analysis predicted that insurers would flee the exchanges under those conditions:
In CBO and JCT’s estimation, under this legislation, about half of the nation’s population would live in areas having no insurer participating in the nongroup market in 2020 because of downward pressure on enrollment and upward pressure on premiums. That share would continue to increase, extending to about three-quarters of the population by 2026.
The CBO predicted that the Medicaid expansion elimination would reduce Medicaid spending by $842 billion over the next decade, and the government would save $454 billion from getting rid of the subsidies. Those savings would be partially offset by the repeal of the taxes — which costs the government $613 billion in revenue—and the end of mandate, for a net deficit reduction of $473 billion.
The analysis comes as Senate Republicans consider whether to vote on the so-called “clean repeal” bill, after their legislation known as the Better Care Reconciliation Act saw enough defections this week to sink it.
In theory, Republicans say, they will work out a replacement plan in the two years before repeal of the ACA subsidies and Medicaid expansion kicks in. However, CBO’s analysis highlights that even in that ideal scenario, some of the legislation’s ugly effects will kick in pretty quickly.
The CBO predicted that in 2018, 10 percent of the population would be living in areas where no insurers would be participating in the individual market. It also said premiums for what are known as “silver plans” under the ACA would rise by 25 percent in 2018, because fewer people would chose to enroll without the mandate and because the mix of those individuals who would remain would be costlier.
In 2018, 17 million more people would not have health insurance coverage than under current law, 10 million of those losses coming from the nongroup market. While those increases are largely fueled by the end of the mandate, the increase in premiums and the departure of insurers from the marketplace would also play a role in reducing coverage, the CBO said.
Come 2020, 27 million fewer people will have coverage compared to current law, and that number would grow to 32 million by 2026. Of the 32 million, 19 million would be due to Medicaid cuts and 23 million to changes in private insurance.
Leaving Obamacare’s regulatory regime in place while taking away its government assistance is partly to blame for those high numbers. The CBO found if the regulations were also repealed, 23 million fewer people would be insured in 2026 compared to current law, instead of 32 million.
Overall, the CBO painted a picture of major instability if the legislation became law, culminating in three out of every four Americans living in an area with no insurers by 2026.
Read the report below: