Republican Health Overhaul Would Leave Millions More Uninsured

  • Bill cuts deficit by $119 billion, less than prior version
  • Many would end up in less generous health-insurance plans

What CBO Estimates Say About the House Health Bill

A health-care bill passed by House Republicans would increase the number of uninsured by 23 million and make coverage costlier for those who need it most, according to the Congressional Budget Office.

The bill to repeal and partially replace Obamacare would also reduce the deficit by $119 billion over 10 years, CBO said. That figure is $32 billion lower than the estimated deficit reduction under an earlier version of the legislation. The CBO released a new estimate of the bill on Wednesday.

The possibility of large numbers of consumers losing access to quality health plans presents a thorny problem for the Senate, which is working on its own bill and has said it may ignore or substantially revise the House legislation. A previous version of the Republican health overhaul proposed in March would have left 24 million Americans without health insurance, the CBO had estimated.

House Republicans passed the legislation in a 217-213 vote on May 4 without a final CBO score.

Late changes made to the bill to win over conservative and moderate holdouts would undermine protections for the sick and destabilize insurance markets for about a sixth of the U.S. population, according to the CBO’s report. The legislation could lead to healthy people buying cheaper policies and sicker people being shunted into more expensive plans or unable to afford coverage, according to the report.

“The agencies expect that premiums would be substantially higher than previously estimated for less healthy people in some states and somewhat lower for the healthier people in those states,” the CBO said. Eventually, premiums could rise to the point that some plans would have no enrollment.

Higher Costs

Amendments made to the original legislation would permit states to seek relief from some insurance rules, freeing plans to charge sick people more and eliminate certain benefits. 

The waivers states are allowed to take would let insurers offer plans that don’t cover some benefits, such as maternity care. That would mean people would have to pay for those treatments on their own, or buy separate insurance coverage for them. An add-on policy that covers maternity care could cost $1,000 a month or more, CBO said -- raising both up-front and out-of-pocket costs for women.

Health and Human Services Secretary Tom Price said the CBO analysis was “wrong” and said, “In reality, Americans are paying more for fewer healthcare choices because of Obamacare, and that’s why the Trump Administration is committed to reforming healthcare.”

Senate Minority Leader Chuck Schumer said the report should be the “final nail in the coffin” in the Republican drive to end Obamacare.

“The report makes clear: Trumpcare would be a cancer on the American health care system, causing costs to skyrocket, making coverage unaffordable for those with pre-existing conditions and many seniors, and kicking millions off their health insurance,” Schumer said.

Senate Hurdles

There are still concerns that the legislation could run into procedural obstacles. Under so-called reconciliation rules that let Republicans block Democrats’ efforts to filibuster a vote, $1 billion of the $119 billion in savings have to fall under the jurisdiction of each of the two Senate committees that oversee the legislation, the Finance Committee, as well as the Health, Education, Labor and Pensions Committee. It may take weeks for that determination to be made.

One outside budget expert, Edward Lorenzen, a senior adviser for the Committee for a Responsible Federal Budget, estimates the policies under the health committee’s jurisdiction could actually cost $12.4 billion, depending on how the Senate parliamentarian rules.

Senator Bernie Sanders, a Vermont independent who is the ranking member on the Senate Budget Committee, said that there are real questions about whether Republicans qualify to use the fast-track reconciliation procedures because the House bill may fail to achieve the required $1 billion in savings from programs under jurisdiction of the Senate health panel.

If that’s the case, Schumer said, the House may need to change its bill and repass it in order for Senate Republicans, who have just 52 votes in the chamber, to use the filibuster-busting tool.

“That means the House has to come back with a new bill and vote again,” he said. “It doesn’t work.”

— With assistance by Billy House, and Steven T. Dennis

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