San Antonio Express-News: 23 million seen losing insurance
Budget offices tallies up GOP plan
WASHINGTON POST
WASHINGTON — Healthcare legislation adopted by House Republicans earlier this month would leave 23 million more Americans without insurance within a decade, and confront many others who have costly medical conditions with coverage that could prove unaffordable, the Congressional Budget Office projected Wednesday.
The finding, which drew immediate fire from Democrats, patient advocates, health industry officials and some business groups, could complicate Republicans' push to pass a companion bill in the Senate.
The new score, which reflects a series of last-minute revisions Republicans made to win over several conservative lawmakers and a handful of moderates, calculates that the American Health Care Act would reduce the federal deficit by $119 billion between 2017 and 2026.
That represents a smaller reduction than the $150 billion CBO estimated in late March, largely because House leaders provided more money in their final bill to offset costs for consumers with expensive medical conditions and included language that could translate to greater federal spending on health insurance subsidies.
Premiums on average would fall compared to President Barack Obama's health care overhaul — a chief goal of many Republicans — but that would be partly because policies typically would provide less coverage, said the report by the nonpartisan budget office.
In some areas of the country, people with pre-existing conditions and others who were seriously ill "would ultimately be unable to purchase" robust coverage at premiums comparable to today's prices, "if they could purchase at all," it adds.
Democrats jumped on the report as further evidence that the GOP effort to repeal Obama's 2010 law — a staple of Donald Trump's presidential campaign and those of numerous GOP congressional candidates for years — would be destructive.
It comes three weeks after the House passed the legislation with only Republican votes, and as Senate Republicans try crafting their own version, which they say will be different.
"The report makes clear that Trumpcare would be a cancer on the American health care system," said Senate Minority Leader Chuck Schumer, D-N.Y., using the nickname Democrats have tried pinning on the bill.
Schumer said the legislation would end up "causing costs to skyrocket, making coverage unaffordable for those with preexisting conditions and many seniors, and kicking millions off of their health insurance."
U.S. Rep. Lloyd Doggett of San Antonio was among Democrats who seized on the CBO report to criticize the GOP legislation.
"CBO confirms that the Republican repeal bill remains a real loser, with millions still losing their access to a family physician while costs soar. Little wonder that Republicans voted first and asked questions later," he said in a statement.
As Republican senators quickly distanced themselves from the updated numbers, what became apparent is the difficult balancing act congressional leaders face as they seek to rewrite large portions of the Affordable Care Act.
Some GOP senators are eager to soften portions of the House bill, including cuts to entitlement programs and a provision that would allow insurers in individual states to offer fewer benefits in their health plans or charge consumers with costly medical conditions higher premiums.
But since those are elements that helped to ensure the AH-CA's passage in the House, it's unclear how a significantly altered Senate bill would fare during reconciliation with the House bill.
Instead of addressing the future number of uninsured Americans under the Republican plan, House Speaker Paul Ryan, R-Wis., chose to focus Wednesday on the CBO's estimate that premiums would fall under the AHCA.
"This CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit," Ryan said in a statement.
Some Republicans, like Sen. David Perdue, R-Ga., said the CBO score has no impact on his chamber's efforts to write its own health legislation.
"Regardless of any CBO score, it's no secret Obamacare is collapsing under its own weight," Perdue said in a statement. "Doing nothing is not an option. The Senate is working now to build on the efforts in the House to make our health care system more affordable and accessible for everyone."
The administration's reaction came from Health and Human Services Secretary Tom Price, who chose to focus on rising premiums under the ACA while faulting the congressional analysts' latest numbers.
"The CBO was wrong when they analyzed Obamacare's effect on cost and coverage, and they are wrong again," Price said.
While House Republicans pressed ahead on a final vote without getting a precise cost estimate in advance, the new CBO projections will now shape what sort of measure can be crafted in the Senate.
To avoid a filibuster, Senate Republicans plan to take the bill up under budget reconciliation rules, which only require a majority vote, but it means the legislation cannot increase the federal deficit within a 10-year window.
The bill the House narrowly passed May 4 meets that test and would begin to dismantle the sweeping 2010 health care law. But Senate Republicans have been working for weeks on their own health care bill and emphasize they have no plans to simply take up the House's legislation.
"The CBO score on the Senate bill is going to be what counts," Senate Majority Whip John Cornyn, R-Texas, said earlier Wednesday.
Joseph Antos, a resident scholar at the libertarian American Enterprise Institute, said the new estimate "is the same signal repeated," conveying that the changes congressional Republicans envision would cut the price of premiums and trim the decifit while leaving more Americans without insurance.
The AHCA's proposal to cut spending on Medicaid by $880 billion over the next decade is the thorniest political issue facing the Senate, Antos said.
"They're going to have to do something on Medicaid, and that something is a real question," he said.