Thread: CBO: Senate GOP health-care bill would leave 22 million more people uninsured by 2026

CBO: Senate GOP health-care bill would leave 22 million more people uninsured by 2026

By Amy Goldstein and Kelsey Snell
June 26 at 5:39 PM

Senate Republicans’ bill to erase major parts of the Affordable Care Act would cause an estimated 22 million more Americans to be uninsured by the end of the coming decade — only about a million fewer than similar legislation recently passed by the House, according to the Congressional Budget Office.

The forecast issued Monday by Congress’s nonpartisan budget scorekeepers also estimates that the Senate measure, drafted in secret mainly by Majority Leader Mitch McConnell and aides, would reduce federal spending by $321 billion by 2026 — compared with $119 billion for the House’s version.

The CBO’s analysis has been awaited as a crucial piece of evidence as McConnell (Ky.) and other Republican leaders try to hurry a vote on the bill this week. But they are navigating an expanding minefield of resistance from their own party’s moderate and conservative wings, while Democrats are united against it.

The additional deficit savings gives those leaders plenty of room to add more spending to win votes from skeptical moderate Republicans like Sens. Dean Heller (Nev.), Rob Portman (Ohio) and Bill Cassidy (La.), who want more money and a dedicated fund to help treat opioid abuse. Senate budget rules require that the final legislation save at least $133 billion, more than was saved in the House bill, giving senators $188 billion to make the bill more palatable.

Any extra spending risks alienating conservatives, however, and could threaten a delicate balance McConnell must strike to win votes from at least 50 of the 52 Senate Republicans. And some moderates have said they will decide whether they can support the Better Care Reconciliation Act based on how it will affect Americans who have gained coverage under the ACA during the past few years.

McConnell said Monday that the legislation is an attempt at finding consensus among Republicans on how to fix health care. He urged a quick timeline for action but said the bill is still a draft that can still be changed ahead of a final vote.

“The American people need better care right now,” McConnell said in a speech on the Senate floor. “This legislation includes the necessary tools to provide it.”

Yet Cassidy, who wants to add better protections for people covered under Medicaid, said that the latest changes to the bill have not gone far enough to win his support.

“It makes me more concerned,” Cassidy said in an interview on CNN. “I remain uncommitted.”

The fresh figures come as President Trump, in a sharp pivot from the praise he initially lavished on the House bill, is urging the Senate to provide Americans more generous help with health insurance. On Sunday, the president repeated during a “Fox and Friends” TV appearance a word he had used in a private White House lunch earlier this month with a group of GOP senators: that the House’s version is “mean.”

According to the 49-page report, the immediate increase in the ranks of the uninsured would be slightly larger than under the House version, with an estimated 15 million fewer Americans likely to have coverage in 2018, compared to 14 million in the House bill.

The Senate’s bill also would reduce federal spending on subsidies for people who buy individual health insurance policies significantly more than the House’s version, cutting spending for tax credits by $408 billion by 2026.

Despite uncertainties about how the bill’s moving parts would play out, the report says: “The amount of federal revenues collected and the amount of spending on Medicaid would almost surely both be lower than under current law. And the number of uninsured people under this legislation would almost surely be greater than under current law.”

Democrats immediately seized on the estimates to criticize Republicans for planning a vote on a bill that would force millions to lose insurance coverage and drive up premiums for seniors. Senate Minority Leader Charles E. Schumer (D-NY) said the bill cannot be fixed despite McConnell’s plan to allow senators to make changes before a final vote.

“Republicans would be wise to read it as a giant stop sign,” Schumer told reporters late Monday afternoon. “No matter how the bill changes around the edges, it is fundamentally rotten at the center.”

Though the ACA’s expansion of Medicaid would be phased out over a longer period of time than in the House legislation, cuts to the public insurance program for the poor still would account for by far the largest share of the reduction in federal spending under the Senate bill — $772 billion over the coming decade.

The CBO has been regarded over its four-decade history as a source of neutral analyses devoid of political agenda. Its current director, Keith Hall, is a conservative economist who served in the administration of President George W. Bush and was appointed to his current role two years ago by a Republican Congress.

Nevertheless, senior Trump aides have repeatedly sought to cast doubt on the budget office’s credibility. “If you’re looking at the CBO for accuracy, you’re looking in the wrong place,” White House press secretary Sean Spicer said on the March day that the budget office issued its cost estimate of a preliminary version of the House GOP’s health-care legislation.

While they differ in important details, both the Senate GOP’s plan and the American Health Care Act narrowly passed by House Republicans in May share the goal of undoing central aspects of the sprawling health-care law enacted by a Democratic Congress seven years ago.

Both bills would eliminate enforcement of the ACA’s mandate that most Americans carry health insurance, relying on subtler deterrents to keep people from dropping coverage. The House version would let insurers temporarily charge higher rates, while the Senate added a provision Monday that would let health plans freeze out customers for six months if they let their coverage lapse.

In different ways, both would replace federal subsidies that help the vast majority of consumers buying coverage through ACA marketplaces, instead creating smaller tax credits that would provide greater assistance to younger adults while making insurance more expensive for people from middle age into their 60s.

After two years, both also would end subsidies that now help about 7 million lower-income people with ACA health plans afford deductibles and copays. And both would repeal an array of taxes that have helped to pay for the ACA’s benefits, including levies on health insurers and on wealthy Americans’ investment income.

For the Senate bill, the CBO’s estimates of insurance coverage and federal spending are influenced by the fact that its forecast covers a 10-year window and the legislation’s most profound changes for the nation’s health-care system are tilted toward the latter part of that period.

The bill would, for instance, leave in place the ACA’s expansion of Medicaid through 2020. After that, it would begin a three-year phaseout of the federal money that under the ACA has paid almost the entire cost of adding 11 million Americans to the program’s rolls in 31 states.

That means the extra funding wouldn’t disappear until the mid-2020s — roughly when sharp new restrictions on federal payments for the entire Medicaid program would take effect.

Over the weekend, the senior Democrat on the Senate subcommittee that oversees the CBO said in a tweet that he had asked the budget office to estimate the Senate bill’s effect on insurance coverage over a longer time horizon. “GOP is hiding the worst Medicaid cuts in years 11, 12, 13 and hoping CBO stays quiet,” wrote Sen. Chris Murphy (D-Conn.)

https://www.washingtonpost.com/natio...=.8b15161893ea

Fox News reported that the CBO reports says insurance premiums would reduce by 30% within a few years. This important fact wasn't in the above article.

So:

We have 22 million more uninsured than the 23 million in the House bill. GOOD!!

We reduce premiums by 30%. GOOD!!

We save $328 billion over 10 years. GOOD!!

And that's all before we "erase the lines" and repeal McCarran which the House has already passed and is waiting on action in the US Senate as well as before all the regulatory changes Secretary Price will make to get in the weeds and clear up the details to make it all run efficiently and more cost effectively.

Listen up, Senate Republicans. You pass this bill on Thursday. It isn't ever going to get any better than this. And you pass that repeal of McCarran bill. I think it's HR 372. It's in the Judiciary Committee. Get it out of committee and on to the floor for a vote. That's where the reduction in premiums will come from, the multi-state and national competition that is currently disabled because of the McCarran-Ferguson Act of 1945.

PASS THE BILL!! By 2026, we won't need "Expanded Medicaid", because everyone in that group will have a great job with good wages, affordable plans or employer paid health insurance offered as a company benefit.

Where was all the out-rage and concern for the 7.5 million American citizens thrown off their Individual Healthcare Plans when
Obamacare was enacted?

There was no outrage. Those are the ones they TAX for not having health insurance. Disgusting.

Hopefully the 22 MILLION are refugees, illegal aliens and their anchor rats, and asylum liars.

Boot them off first!

VERIFY FIRST all Doctor's offices and Hospitals and notify ICE.

Fast track the pregnant ones out of here.

Senate needs to pass this bill on Thursday. The people on expanded Medicaid need to get off this program, find better jobs, get more hours and try to find work with employers who offer insurance benefits. This bill will help make that happen because it will promote the tax cut and tax reform bill which when that passes, JOBS are going to explode, wages will rise naturally, more benefits will be offered because with this bill and the repeal of McCarran, there will be all types of employer group plans that are much more cost effective than what is offered now.

Older Americans, regardless of whether they receive subsidies, could pay much higher premiums under the GOP plan because both the House and Senate bills would allow insurance companies to charge older people up to five times more than what they charge younger people. Under current law, they cannot charge more than three times more.

These changes would mean that among the low-income population that buys subsidized insurance on the exchange, older people in their 60s would see large spikes in premiums, while some younger people in their 20s would see modest decreases in premiums. Under the Senate plan, generally, the poorer and older you are, the more your premiums would rise.

@ http://www.sfgate.com/business/artic...e-11248348.php

Too many people aren't taking into account the power of a free enterprise multi-state and nationwide market, probably because they either don't understand the free enterprise market or they don't want to see Obamacare repealed for political reasons. No one's premiums are going to go up under this bill, they're all going to go down.

People are getting lost in the weeds. There are 4 crucial characteristics of this bill that matter:

1. removing the mandates
2. removing the penalties
3. phasing out the subsidies for insurance companies and replacing them with tax deductions/tax credits for the insured person/family
4. accounting for companion bill to repeal health insurance from McCarran-Ferguson Act of 1945 (erasing the lines)

Those are the most important aspects of this bill, because they not only repeal what's wrong with Obamacare, they will fix the problem that led to the insurance issue to begin with, lack of competition across state lines and adequate federal trade regulation the same as every other business in the United States.

It also overlooks the timing of the phase out. Most people in their 60's now who are not already on Medicare will be on Medicare by the time this goes into effect. Those on Expanded Medcaid won't be impacted at all until 2026 and at that point the States will handle more of that issue than they are now. Feds still contribute but with a cap. This motivates States to create good jobs in their States, to protect their American Workers, to discourage importing poverty workers and illegal aliens who will now be costing the state instead of being a funnel for more federal dollars into their state by selling out our American Workers.

Too many Democrats and even some Republicans are lost in the weeds of socialism. They think a reduction in the COLA for Medicaid Expansion is a "cut". No it isn't. It's an adjustment to reduce the growth of a socialist program that feeds the beast. They think changing the Medicaid Expansion program to a more state-oriented program is abandoning low income Americans. No it isn't. It's changing who pays for some of it and giving States more options and flexibility to solve the needs of their low income population. If Medicaid is bankrupting states, it's not because of the federal government, it's because the state hasn't addressed its unemployed and underemployed situation.

I find it humorous that Ron Johnson would be opposing this bill while at the same time proposing his own bill that would increase foreign low cost labor flowing into Wisconsin. You can't solve problems with this type of Confused Senator.

So GOP, set 'em straight, get 'em all on board, and demand they pass this bill on Thursday, so we can move on to tax cuts and tax reform that will kick this economy into an historic run for the money and create tens of millions of good jobs for American Workers who won't need or want Expanded Medicaid by the time the lower COLA adjustments take effect.

Personally, I don't understand why there's any COLA adjustment for Medicaid to begin with. If you're trying to reduce or control costs of medical care why would you feed it with automatic COLAs for Medicaid that are higher than CPI? It's outrageous. No wonder the "Nurses Associations" and "Hospital Associations", hate the bill. This feeds their own paychecks and earnings statements, not poor and low-income patient services.

Also, remember, there are thousands and thousands of pages of "regulations" that are part and parcel to this Obamacare mess. Price and DHHS will fix all that crap and make the system much more stream-lined and effective. There's no way at this point to evaluate what those cost savings and result benefits will be, other than to know they will be ..... HUUUGE!!!

So just pass the damn bill on Thursday and get this show on the road. It's time to play ball and start winning the game on health insurance, tax cuts, good jobs with good benefits. We need an end to phony political grand-standing, and that's all it is, just grand-standing for special interest donors by a few Confused Senators.