Despite enormous concern over how many people might lose insurance, Paul Ryan finally managed to get his bill to repeal and replace the Affordable Care Act through the House. The act itself is something of a mess, and it quickly came out that Ryan was sitting on the bill, hoping the Congressional Budget Office would deliver good news so he could deliver it to the Senate. The CBO did not deliver good news.
Delayed a day, the CBO has officially scored the bill and, well, we’ll let the highlights speak for themselves. All emphasis below has been added by the author of this post:
CBO and JCT estimate that enacting that version of H.R. 1628 would reduce the cumulative federal deficit over the 2017-2026 period by $119 billion. That amount is $32 billion less than the estimated net savings for the version of H.R. 1628 that was posted on the website of the House Committee on Rules on March 22, 2017, incorporating manager’s amendments 4, 5, 24, and 25.
This is worse than it sounds; these cuts are part of Trump’s and the GOP’s budget plans. The lower the number, the more difficult the budget process is going to be. The report immediately follows it up as follows:
In comparison with the estimates for the previous version of the act, under the House-passed act, the number of people with health insurance would, by CBO and JCT’s estimates, be slightly higher and average premiums for insurance purchased individually—that is, nongroup insurance — would be lower, in part because the insurance, on average, would pay for a smaller proportion of health care costs. In addition, the agencies expect that some people would use the tax credits authorized by the act to purchase policies that would not cover major medical risks and that are not counted as insurance in this cost estimate.
In short, the act would cause people to pay less and get less insurance, or to use the government’s money to buy crappy insurance that doesn’t actually protect them. The kicker is that over time, this would also mean more and more Americans wouldn’t be insured at all:
CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law.
What happens next? Even in May, the bill Ryan pushed through only barely squeaked by in the House. If he’s forced to resubmit it and revise it, as now seems likely, he’ll once again have to twist more arms in a House while eyeing what looks to be an increasingly difficult 2018 election cycle. Adding to the problem, the Senate has made it clear it has no intention of considering the House law, even if it did achieve a good CBO score. So, it appears, Ryan can either try to submit the bill or return, yet again, to the drawing board.
Also, Bernie Sanders may have subtweeted this news (or any other disgraceful tidbit that dropped at some point today).