President Trump’s proposed repeal and replace of Obamacare would result in 23 million fewer people having health insurance by 2026, according to a new analysis released Wednesday evening by the nonpartisan Congressional Budget Office.
In its first analysis of the bill that Republicans in the House of Representatives passed in early May, the CBO concluded that out-of-pocket costs for mental health and maternity care would increase by thousands of dollars a year in many states. The CBO predicted that the health bill would create government savings of $119 billion over the next 10 years.
Out-of-pocket costs to Americans would depend on which states chose to request a waiver from Obamacare’s “Essential Health Benefits,” a package of coverage requirements including maternity and substance abuse care that conservatives argue artificially inflate insurance costs and Democrats believe prevent insurance companies from peddling skimpy plans.
The waivers are the central difference between this version of Trumpcare and the version that failed to pass the House in March, which the CBO predicted would result in 24 million fewer people having health insurance.
House Republicans argued that the two versions were not that different, which is why they decided to vote without a CBO score. While the topline numbers are similar — 23 million vs. 24 million — the report suggests that the new bill would make some dramatic changes in the insurance market.
The CBO posits that at least one-sixth of the population — over 50 million people — could be dramatically affected by these new waivers and be subjected to “unstable” insurance markets beginning in 2020.
Such changes could significantly increase costs for people with pre-existing conditions and ultimately price them out of the insurance markets. The CBO also predicts that premiums for young, healthy people would go down but significantly increase for older, sicker people.
The bill that failed in March also included $150 billion in savings, $31 billion more than this iteration. Maintaining billions in savings was required in order to pass the bill through the Senate’s reconciliation rules — which will allow Republicans to pass Trumpcare without any votes from Democrats. House Speaker Paul Ryan had put off sending the bill to the Senate until it was clear that the new bill still included sufficient savings.
Next, the Senate Parliamentarian — an obscure unelected official who is the keeper of the legislative body’s rules — will have to determine if the bill will qualify for reconciliation.
Senate Republicans were quick to downplay the significance of the new CBO score, saying they’re walking their own path on health reform and many changes will still be made.
“This is not a finished journey,” Sen. James Lankford of Oklahoma told MSNBC. Many other Republicans, like Rob Portman of Ohio and Shelly Moore Capito of West Virginia, have already publicly objected to the $800 billion decrease in Medicaid spending.
Minority Leader Chuck Schumer said the CBO report is evidence that Senate Republicans should throw the House bill in the garbage and work with Democrats on a reform bill. But Democrats, including Schumer, were rallying across the country to protect Obamacare before Trump was inaugurated, so it’s unclear if there is common ground.
Senate Majority Leader Mitch McConnell seems to think so, telling reporters yesterday, “We’re not going to waste our time talking to people who have no interest in fixing the problem.”