Paul Ryan touted his plan to repeal the Affordable Care Act as an “act of mercy,” which may be news to the 15 million people who stand to lose health insurance coverage if his alternative American Health Care Act is signed into law.
Despite Donald Trump’s promise to have “insurance for everybody,” the Brookings Institution released an analysis today which found that 15 million people stand to lose coverage under Trump’s preferred replacement plan.
“In anticipation of the official CBO estimates,” Brookings researchers Loren Adler and Matthew Fiedler used prior Congressional Budget Office (CBO) “estimates and analysis to assess how CBO will likely expect this legislation to impact insurance coverage.”
As a starting point, CBO recently estimated the effect of one important provision of the House legislation: repealing the individual mandate. CBO estimated that repealing the mandate would cause many people, especially healthy people, to drop their insurance coverage. That, in turn, would drive premium increases in the individual health insurance market, causing still further coverage losses.
In total, CBO estimated that individual market premiums would rise by 20 percent and that 6 million people would lose individual market coverage by 2026. On top of that, CBO estimated that repealing the individual mandate would reduce the number of people with employer coverage by 2 million and reduce Medicaid coverage by 7 million, bringing the total coverage loss to 15 million.
CBO previously estimated that repealing the individual mandate would cause 15 million fewer people to have health insurance. From our analysis, it appears unlikely that potential coverage gains from the legislation’s late enrollment penalty and grants to states are enough to make up for the additional coverage losses from the elimination of the enhanced federal match rate for the ACA’s Medicaid expansion population and the legislation’s per capita cap.
The precise coverage impacts of the legislation’s changes to the structure of individual market subsidies are uncertain, but our view is that the CBO will mostly likely conclude that these provisions result in a reduction in individual market coverage that adds to the coverage losses caused by repeal of the individual mandate.
On Tuesday, S&P Global Ratings estimated that up to 10 million people would lose health coverage under the GOP's proposed Obamacare replacement.