Insurance

CBO: 24 million would lose health insurance under GOP plan

But Republicans point to savings of $337 billion through 2026

By Dan Freedman

Photo: Michael P. Farrell

The long-awaited Congressional Budget Office analysis of the GOP’s Obamacare replacement painted a grim picture of America’s health care system if the measure becomes law, projecting 24 million would lose insurance by 2026.

If the Republicans’ American Health Care Act does indeed replace the Affordable Care Act — Obamacare — 14 million would be uninsured by 2018, said CBO, which released the report Monday.

Although the Trump administration and congressional Republicans had attempted to low-ball expectations and pre-emptively criticize the report as biased, the CBO projection is the closest thing Washington has to neutral scorekeeping.

Congressional Republicans appointed CBO’s director, Keith Hall, in 2015. Hall served on the Council of Economic Advisers in the administration of former President George W. Bush.

Not surprisingly, Democrats unfurled their “I-told-you-so” flags, while Republican supporters of Obamacare “replace and repeal” focused more on the parts of the report that calculated the GOP plan would reduce the deficit by $337 billion through 2026, and that rising health insurance premiums would start to fall after 2020.

“When people have more choices, costs go down,” said House Speaker Paul Ryan. “That’s what this report shows. And, as we have long said, there will be a stable transition so that no one has the rug pulled out from under them.”

Republicans have said Obamacare is in a death spiral. But their plan already is meeting strong headwinds on Capitol Hill from Republican conservatives — who think it doesn’t go far enough in dismantling Obamacare — and moderate Republicans, who think it goes too far.

Democrats, who are for the most part united in their opposition, were poised to exploit the gap created by the report.

“The CBO’s estimate makes clear that TrumpCare will cause serious harm to millions of American families,” said Senate Minority Leader Charles Schumer. “The CBO score shows just how empty the president’s promises, that everyone will be covered and costs will go down, have been. This should be a looming stop sign for the Republicans repeal effort.”

“The CBO report confirms what we already knew,” said Sen. Kirsten Gillibrand. “Trumpcare will force millions to lose their insurance, cost seniors and families more, and give high-priced tax breaks to insurance companies at the expense of middle-class workers.”

Last week, Republican leaders in the House hastily pushed the bill through two committees in anticipation of political blowback after release of the CBO report.

“I was discouraged for my constituents when Republicans raced the clock to ram this bill through our committee last week,” said Rep. Paul Tonko, D-Amsterdam, who attempted to forestall the measure’s passage through the House Energy & Commerce Committee. “Now we can see why.”

Backed by President Donald Trump, the GOP plan changes virtually all of the architecture of Obamacare, which became law in 2010. After 2020 it continues the Obamacare tax credits for purchasing health insurance but bases them on age rather than income. It ends the expansion of Medicaid that in New York had provided insurance to those just over the poverty line, replacing it with a benefit for all Medicaid recipients capped at 2016 levels.

New York’s Medicaid population of around five million is second only to California. Of the five million, about 2.1 million get insurance through Obamacare’s Medicaid expansion, according to data compiled by the nonpartisan Kaiser Family Foundation.
Health-care advocates said the CBO report illustrated the potential negative effects of the GOP plan for New York, with its mix of urban and rural poverty.

“It’s a big step backward for low-income New Yorkers,” said Bea Grause, president of the Healthcare Association of New York State, which represents 500 not-for-profit and public hospitals, nursing homes, and organizations statewide.

Without insurance, Grause said, low-income individuals and families might put off needed doctor visits and wait until treatable conditions become acute before seeking care in the system’s most expensive locale — the hospital emergency room.
Hospitals generally attempt to defray such costs through compensation payments from Washington and rate hikes to insurers — all of which are ultimately passed on to taxpayers and those with health insurance.

The Republican plan “saves the federal government money, but just means the state and the taxpayers will foot the bill,” Grause said. “It’s a cost shift. The demand does not go away.”

Times Union

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