The Congressional Budget Office is projecting that 14 million Americans will lose their health insurance coverage by 2018 if the House Republicans healthcare bill goes into place.
An even greater number, 24 million, are forecast to lose coverage by 2026, the non-partisan congressional scorekeeper said in a report today, as changes to subsidies and Medicaid go into effect.
Those numbers are in contrast to how many people are insured under the current healthcare law, the Affordable Care Act, also known as Obamacare.
At the White House shortly after the announcement, Health and Human Services Secretary Tom Price said, ‘We disagree strenuously.’
‘It basically says that we’ll be back at pre-Obamacare status. That about 40 million people uninsured in this country,’ Price said.
‘We believe the plan we’re putting in place will insure more individuals than are currently insured,’ Price continued. ‘So we believe CBO simply has it wrong.’
Keith Hall, who leads the CBO, was hand-picked to run the agency by Price, a former congressman who was chair of the House Budget Committee at the time.
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Health and Human Services Secretary Tom Price said the White House ‘disagreed strenuously’ with the CBO’s estimate that 24 million people would lose health coverage under the House Republican plan by 2026
House Speaker Paul Ryan (pictured) is one of the biggest proponents of the Republican plan, which was rolled out last week and passed through committees
Today before the numbers were released, President Trump held a ‘listening session’ with ‘victims of Obamacare’ in the Roosevelt Room of the White House
Earlier in the day, White House Press Secretary Sean Spicer tried to sow doubt in the soon-to-be-released numbers from the CBO.
‘If you’re looking to get a bull’s eye accurate prediction to where it’s going, the CBO was off by more than half last time,’ Spicer told reporters at the briefing.
Meanwhile, President Trump had hosted people to the White House today to tell Obamacare horror stories.
Republicans were expecting the numbers from the Congressional Budget Office to not be so great, with House Speaker Paul Ryan saying yesterday that one can’t compare the Republicans’ new program to the existing one because the government will no longer be forcing Americans to buy health insurance.
Talking to CBS News’ John Dickerson, Ryan said he fully expected the CBO to say ‘Not as many people will get coverage.’
‘You know why?’ Ryan asked Dickerson. ‘Because this isn’t a government mandate. This is not the government makes you buy what we say you should buy and therefore the government thinks you’re all going to buy it.’
The Affordable Care Act mandates that people get covered, or they must pay a tax penalty.
Republicans want to kill off this mandate as they seek to repeal and replace the law.
In the CBO’s report, this is what accounts for the first big increase in those who would be uninsured by 2018.
Citing the 14 million figure, the report says, ‘most of that increase would stem from repealing the penalties associated with the individual mandate.’
The legislation calls for swapping out the current Obamacare subsidies with tax credits, expanding health savings accounts and phasing out a planned expansion of Medicaid.
Once these aspects of the law go into effect, that’s where the number of uninsured Americans ticks up again.
According to the report: ‘Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026.’
‘The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped,’ the report continued.
‘In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,’ the report added.
That is nearly double.
The CBO and the Joint Committee on Taxation found that the new law would reduce federal deficits by $337 billion over the 10 year period starting this year and concluding in 2026.
This money would be saved by tax dollars no longer paying for subsidies and because of the reductions in Medicaid.
The healthcare market, the report said, will remain stable under the new plan.
‘Even though the new tax credits would be structured differently from the current subsidies and would generally be less generous for those receiving subsidies under current law, the other changes would, in the agencies’ view, lower average premiums enough to attract a sufficient number of relatively healthy people to stabilize the market,’ the report said.
As for the price of Americans’ premiums, in 2018 and 2019, the CBO believed that premiums would rise by 15 to 20 percent more than what they would have cost under Obamacare, but by 2020, premiums would go down and be cheaper than what’s expected under the Affordable Care Act.
The initial price increase would be caused by people leaving the insurance market because they’re no longer mandated to buy insurance.
By 2020, the cost would be offset by grants to states from the Patient and State Stability Fund, which would defray the cost to insurers for those with high-dollar claims.
Additionally, the Republicans’ plan calls for killing regulations that require insurers to offer plans that cover a certain percentage of healthcare costs.
This would bring the cost of premiums down too.
Finally, the CBO tabulated that there would be a younger pool of people in the insurance market, which would also bring premium cost down.
But for those Americans hoping to see savings, age will matter, the report says.
The new law allows insurers to charge five times more for older enrollees than young ones.
The current law holds this price disparity to three times the cost of a young person’s insurance.
‘Although average premiums would increase prior to 2020 and decrease starting in 2020, CBO and JCT estimate that changes in premiums relative to those under current law would differ significantly for people of different ages because of a change in age-rating rules,’ the report said.
While the White House complained about the CBO’s estimate of the number of people who would lose insurance, Ryan pointed out the better parts of the report.
‘This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care,’ the House speaker said. ‘CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation.’
‘These are things we are achieving in just the first of a three-pronged approach,’ Ryan noted.
Price echoed that point, standing outside the White House today.
‘Apparently what CBO looked at is simply the bill that’s pending before Congress. It didn’t look at the regulatory reforms that we’re going to put in place,’ he said.
‘It didn’t look at all of the pieces of legislation that are also pending out there that we call on our friends on the other side of the aisle to help us reform the insurance market so that we can provide for greater choices and greater competition,’ Price added.
While the HHS secretary was correct in saying that Republicans will need at least eight Democratic votes in the Senate to push other healthcare reform bills through, the current piece of legislation is already in a politically tricky place and today’s CBO numbers likely won’t help.
The plan for this bill was to pass it through a Senate process called reconciliation, which means only a simple majority are needed to get it passed.
House Speaker Nancy Pelosi wondered how Republicans could look their constituents in the eye when 24 million of them could lose health insurance
However, conservative Republican senators have dubbed the House Republican bill ‘Obamacare Lite,’ calling the GOP peers to strip the tax credits out of the legislation, to further reduce costs.
Conservatives also want to see Medicaid phased out faster.
Democrats have never wanted to have anything to do with this bill and today’s news further cements that.
‘How can they look their constituents in the eye when they say to them 24 million of you are no longer going to have coverage,’ remarked House Minority Leader Nancy Pelosi, D-Calif., Monday evening on Capitol Hill.
When is was Senate Minority Leader Chuck Schumer’s turn to speak, the New York Democrat played up the connection between Price and the head of the CBO.
‘Now, the Republican hand-picked head of CBO has confirmed what we Democrats have been saying all along, Trumpcare would be a nightmare to the American people, causing tens of millions to lose coverage and millions more seeing the costs of their healthcare go up,’ Schumer said.
Senate Minority Leader Chuck Schumer called the bill ‘Trumpcare’ at a press conference today
Of the 24 million who could lose healthcare coverage, Schumer added, ‘That’s un-American and that’s wrong.’
Schumer also picked up on CBO’s statements about older Americans’ healthcare expenses going up, as the new law would permit insurance companies to charge them higher rates, at least until the age of 65 when people would then be eligible for Medicare.
‘If there was ever a war on seniors, this bill, Trumpcare, is it,’ Schumer said.
Price said the GOP’s plan is necessary to keep the market from collapsing in the five states where there is currently a solo insurer providing coverage.
‘You tell me that that’s what the plan was,’ he said of Democrats’ health law.
‘The fact is that those folks have no choice whatsoever. The fed government has destined them to only have one opportunity to purchase coverage, and if that’s not what they want, then tough luck. That’s not our plan.’
Ryan, too, touted the fact that the Republican plan will allow for more choice.
‘Our plan is not about forcing people to buy expensive, one-size-fits-all coverage,’ Ryan said. ‘It is about giving people more choices and better access to a plan they want and can afford.’
Before he left the microphones, Price denied that he was trying to tell legislators to trash the CBO’s report, despite the administration’s concerted campaign to disparage the government office in advance of its release.
‘No, we will read the report, look into the report beyond the toplines and we’ll have further comment tomorrow,’ Price said.
Office of Management and Budget Director Mick Mulvaney was then asked if the administration planned to scrap the plan because of the discouraging numbers.
‘Absolutely not. No. No. No,’ Mulvaney replied.