32 million people will lose insurance if Republicans repeal Obamacare, CBO finds

If Congress repeals large parts of the Affordable Care Act without a replacement, 32 million Americans will lose insurance and premiums will double over the next decade, the Congressional Budget Office found in a Wednesday report.

The unfavorable report from by the nonpartisan office arrived as Republicans are scrambling to pass any kind of health care legislation, whether by replacing Obamacare entirely or by repealing its key components. Earlier this week, Senate Majority Leader and Kentucky Republican Mitch McConnell said he wanted to move ahead with straight-repeal legislation, but it’s unclear if that will happen — Republicans currently lack the votes needed to pass either option.


This CBO score is an updated analysis that the office did back in 2015, when Congress also passed legislation that would’ve repeal Obamacare. Obama vetoed that bill, but in a Wednesday tweet and a Thursday pep talk for struggling Republicans, Trump made it clear that he’s fine with signing an outright repeal.

“We can repeal, but we should repeal and replace, and we shouldn’t leave town until this is complete,” Trump told Republicans Thursday. “And this bill is on my desk and we can sign it and celebrate for the American people.”

Here are the main takeaways from this CBO report:

  • This straight repeal would eliminate states’ expansion of Medicaid eligibility and Obamacare’s individual mandate, among other provisions, but retain regulations protecting people with pre-existing conditions and mandate that plans continue to offer specific benefits.
  • By 2018, 17 million more people will be without insurance than if the Affordable Care Act is left intact. By 2020, that number would grow to 2020.
  • Should the repeal take effect, the CBO predicts, insurers will leave the Obamacare individual marketplace in droves. By 2020, half the country will be living in areas where no individual coverage options could be found. By 2026, two-thirds of the nation’s population will be living in places that lacked individual coverage plans.
  • Changes to Medicaid will lead the program to lose about $842 billion in funding over the next 10 years and leave 19 million people without coverage.

But this bill isn’t all bad news for the government: Between 2017 and 2016, the CBO predicts, federal deficits will decrease by about $1.1 trillion in total.

The CBO has not yet released a report calculating the effects of the most recent bill that proposes to replace Obamacare, which includes an amendment from Texas Republican Sen. Ted Cruz that would free insurers from having to offer only plans that comply with Obamacare rules. Supporters say that this will allow Americans to have more flexibility when choosing their healthcare plans — for example, men wouldn’t have to pay for plans offering maternity care — while critics argue that such a bill will leave people with pre-existing conditions with “virtually no real insurance.”