On Tuesday, the Congressional Budget Office (CBO) released its estimate of how many people will become uninsured if Republicans move forward with their likely plan to repeal the Affordable Care Act, and the numbers are brutal. Thirty-two million people would lose their health insurance by 2026, and premiums would double in the same time frame.
Americans would also see a sharp and immediate drop in insurance rates. According to the CBO, “the number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill.”
The CBO examined a bill pushed by Republicans in the previous Congress, the “Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015,” which would phase out provisions of the Affordable Care Act that help make health insurance affordable — including subsidies for plans purchased on Obamacare exchanges and the law’s Medicaid expansion. It would also immediately repeal provisions, such as the law’s individual mandate, which are intended to bring people into the insurance market.
At the same time, this bill would also leave in place certain regulatory reforms, such as the requirement that insurers cover people with preexisting conditions.
Such a partial repeal is necessary because current Senate rules allow the law’s fiscal provisions to be abolished with only 51 votes, but its regulatory provisions require 60 votes to overcome a filibuster threat. As Republicans control only 52 votes in Congress, full repeal is not possible under current rules absent significant and unlikely Democratic defections.
Nevertheless, partial repeal would lead to a massive expansion of the uninsurance rate. Indeed, many people would be unable to obtain insurance at any price. As CBO explains, “roughly 10 percent of the population would be living in an area that had no insurer participating in the nongroup market.”
A Massachusetts study found that “for every 830 adults gaining insurance coverage there was one fewer death per year.” If this figure is applied to the 32 million who will lose insurance if key provisions of Obamacare are repealed, it means that about 38,500 people will die every year who otherwise would have lived in Republicans succeed in their plans to eviscerate the Affordable Care Act.
Almost immediately after the CBO report became public, a member of the Republican House leadership questioned its findings.
CBO misses the point. Obamacare will be replaced with lower costs and more choices.
— Rep. Steve Scalise (@SteveScalise) January 17, 2017
Republicans have indeed suggested several possible replacements for the Affordable Care Act, such as dismantling state insurance regulation, giving states more leeway to deny Medicaid coverage to people who are now eligible, and tax cuts that would primarily benefit the wealthy. To date, they have not settled on a specific replacement plan, however, and the ideas they have floated so far would insure only a fraction of the people currently insured under the Affordable Care Act.