WASHINGTON (AP) ā The health care bill Republicans recently pushed through the House would leave 23 million more Americans without insurance and confront others who have costly medical conditions with coverage that could prove unaffordable, Congressā official budget analysts said Wednesday.
Premiums on average would fall compared with President Barack Obamaās health care overhaul ā a chief goal of many Republicans ā but that would be partly because policies would typically provide fewer benefits, said the report by the nonpartisan Congressional Budget Office.
In some regions, people with pre-existing medical conditions and others who were seriously ill āwould ultimately be unable to purchaseā robust coverage at premiums comparable to todayās prices, āif they could purchase at all,ā the report said. That was a knock on 11th-hour changes Republicans made in the bill to gain conservativesā votes by letting states get waivers to boost premiums on the ill and reduce coverage requirements.
The report said older people with lower income would disproportionately lose coverage. Over half of those becoming uninsured, 14 million people, would come from the billās $834 billion in cuts to Medicaid, which provides health coverage to poor and disabled people, over 10 years.
Democrats cited the analysis as further evidence that the GOP effort to repeal Obamaās 2010 law, a staple of Donald Trumpās presidential campaign and those of numerous Republican congressional candidates for years, would be destructive. It comes three weeks after the House narrowly passed the legislation with only Republican votes, and serves as a starting point for Senate Republicans trying to craft their own version, which they say will be different.
āThe report makes clear that Trumpcare would be a cancer on the American health care system,ā said Senate Minority Leader Chuck Schumer, D-N.Y., using the nickname Democrats have tried pinning on the bill. Schumer said the legislation would end up ācausing costs to skyrocket, making coverage unaffordable for those with pre-existing conditions and many seniors, and kicking millions off of their health insurance.ā
Trumpās Health and Human Services secretary, Tom Price, assailed the CBO for being inaccurate, with the White House issuing a similar critique.
āThe CBO was wrong when they analyzed Obamacareās effect on cost and coverage,ā Price said of the agencyās report on Obamaās law, āand they are wrong again.ā
Many congressional Republicans took a sharply different tack, emphasizing some of the reportās more positive findings.
āThis CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit. It is another positive step toward keeping our promise to repeal and replace Obamacare,ā said House Speaker Paul Ryan, R-Wis.
The analysis said the House bill, the American Health Care Act, would reduce federal deficits by $119 billion over the next decade. The previous version of the bill reduced shortfalls by $150 billion.
Trump and Republicans celebrated the Houseās narrow May 4 passage of the bill in a Rose Garden ceremony after several embarrassing setbacks, even as GOP senators signaled it had little chance of becoming law without significant changes.
In a late compromise, House GOP conservatives and moderates struck a deal that would let states get federal waivers to permit insurers to charge higher premiums to some people in poor health, and to ignore the standard set of benefits required by Obamaās statute.
CBO said states adopting those waivers could destabilize coverage for people with medical problems. The agency estimated that about one-sixth of the population ā more than 50 million people ā live in states that would make substantial changes under the waivers.
The budget office projected that premiums in those states would be lower for healthy people than under current law because their coverage would be narrower, but did not estimate an amount.
For ill people in those states, āit would become more difficultā for seriously ill people to buy insurance ābecause their premiums would continue to increase rapidly,ā the report said.
Benefits likely to be excluded from required coverage in some states would include maternity, mental health and substance abuse services, the report said. It said consumersā out-of-pocket costs for those services ācould increase by thousands of dollars in a given year for the (patients) who use those services.ā
In states not getting waivers, where it estimated half the country lives, average premiums would be about 4 percent lower in 2026 than under Obamaās law, the report said. For the one-third of the nation where states would modestly reduce coverage requirements, average premiums would be about 20 percent lower, the analysts estimated.
The budget office said average premiums in those states would go down because younger and healthier people would buy coverage and the policies would cover less.
The report said that under Obamaās law, the nationās health insurance market is expected to remain āstable in most areasā because federal subsidies to millions of consumers largely rise with premiums. Citing markets where insurers have left or sought huge premium increases, Republicans have repeatedly said the statute must be dismantled because it is in a death spiral.
Without naming the Trump administration, the report said factors encouraging insurers to flee some markets include lack of profits and āsubstantial uncertaintyā about federal actions.
Trump has suggested the IRS wonāt enforce penalties against people who donāt buy coverage, as Obamaās individual mandate requires. He has also left uncertain whether the government will continue payments to insurers that let them lower out-of-pocket costs like copayments and deductibles ā reductions they are legally required to make.
