The U.S. Senate bill overhauling Obamacare would result in 22 million fewer Americans with health insurance by 2026 and $772 billion less in Medicaid spending if it becomes law, according to a heavily anticipated estimate from the Congressional Budget Office.
The nonpartisan analyst tasked with understanding the impact of major legislation also said the bill would remove 15 million additional people from the insurance rolls in 2018 alone. It’s expected to cut the federal deficit by $321 billion over a decade.
The CBO’s report on the expected impact of the Senate Republican bill is fairly similar to its analysis of the House of Representatives bill, which predicted 24 million people would lose coverage and older, poorer Americans would see sharp increases in costs. That report — along with widespread unpopularity of the House bill — helped prompt congressional Republicans to give up on passing the first iteration of the law in late March. (Though the House subsequently passed a slightly modified version of the bill in May.)
The findings on the Senate bill likewise complicate Republican efforts to pass the Senate bill in a vote expected this week.
They’re also at odds with statements from prominent Republicans in Congress and in the Trump administration who have been pushing publicly for the Senate bill in recent days. Here’s a sampling of what these Republicans said, and what the CBO says on the same topic.
Kellyanne Conway, counselor to the president, on ABC’s “This Week with George Stephanopolous,” June 25, 2017:
“These are not cuts to Medicaid, George. This slows the rate for the future and allows governors more flexibility with Medicaid dollars because they’re closest to the people in need. If you are currently in Medicaid, if you became a Medicaid recipient through the Obamacare expansion, you are grandfathered in. We’re talking about in the future.”
CBO: The report notes that between 2017-2026 the country will see “reduction of $772 billion in federal outlays for Medicaid.”
Secretary of Health and Human Services Tom Price on CNN’s “State of the Union,” June 25, 2017:
“The plan in its entirety will absolutely bring premiums down. Because you increase competition, you increase choices for individuals, you allow folks to be able to purchase the kind of coverage that they want, not just the government forces them to buy. Those are all of the secret keys to a market that actually works for health care and works for patients. That’s the key.
CBO: True, broadly speaking. While premiums could spike in the short-term if the Senate bill were to become law by “2026, average premiums for benchmark plans for single individuals in most of the country under this legislation would be about 20 percent lower than under current law.” However, the CBO pointed out that premiums on the Obamacare exchanges would be lower because plans would offer skimpier benefits. “Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law,” CBO analysts wrote. It’s also worth pointing out that while premiums might be down on average, some groups such as older, poorer Americans would see much higher premiums.
Sen. Pat Toomey, Republican of Pennsylvania, on CBS’ “Face the Nation,” June 25, 2017:
“And this bill provides very generous tax credits, considerably more generous than the House. They’re more oriented toward lower-income people, and those are the people who obviously need it.”
CBO: “The premium tax credits would be smaller in most cases than under current law and subsidies to reduce cost sharing — the amount that consumers are required to pay out of pocket when they use health care services — would be eliminated starting in 2020.”