Obamacare revision would reduce insured numbers by 24 million, CBO projects

WASHINGTON – House Speaker Paul Ryan’s proposal to revise the Affordable Care Act would lower the number of Americans with health insurance by 24 million while reducing the federal deficit by $337 billion by 2026, congressional budget analysts said Monday.

According to a Congressional Budget Office projection, 14 million fewer people would have health insurance next year alone. Premiums would be 15 percent to 20 percent higher in the first year compared with the Affordable Care Act and 10 percent lower on average after 2026. By and large, older Americans would pay “substantially” more and younger Americans less, the report said.

The report from the Congressional Budget Office fueled concerns that the GOP health care plan would prompt a dramatic loss in health insurance coverage, potentially contradicting President Donald Trump’s vow that health care reform would provide “insurance for everybody” and threatening support from moderate Republican lawmakers.

Yet it also boosted House leaders’ efforts to persuade skeptical conservatives, who felt that the measure did not go far enough in repealing the Affordable Care Act, to support what the CBO now predicts will be deficit-reducing legislation.

The analysis immediately prompted a clash of reactions between the White House and Republican leaders. Trump’s budget director, Mick Mulvaney, said the report is “just absurd,” and Health and Human Services Secretary Tom Price said: “We disagree strenuously” with it.

Ryan defended the report, saying that it proves that the proposal will “dramatically” reduce the deficit and usher in “the most fundamental entitlement reform in a generation.”

“Our plan is not about forcing people to buy expensive, one-size-fits-all coverage,” he said. “It is about giving people more choices and better access to a plan they want and can afford. When people have more choices, costs go down. That’s what this report shows.”

The release of the CBO’s report marks the beginning of a new phase in the debate over the week-old health care bill, which is moving through the House on an accelerated timetable despite opposition from Republicans, Democrats and virtually every sector of the U.S. health care industry. Conservative Republicans, in particular, have demanded changes to the measure in exchange for their support.

The CBO report offered conclusions that might neutralize some conservative concerns, perhaps softening those members’ opposition to the measure.

The conservative House Freedom Caucus did not immediately provide a response to the report.

At the same time, some moderate Republicans expressed concerns about the number of people who would lose coverage.

“These kinds of estimates are going to cause revisions in the bill, almost certainly,” said Sen. Susan Collins, R-Maine.

“I don’t think that the bill that is being considered now is the bill that ultimately will be the one that we vote on in the Senate.”

Democrats cited the CBO numbers to support their flat-out opposition to the plan.

“The CBO score shows just how empty the president’s promises, that everyone will be covered and costs will go down, have been,” said Senate Minority Leader Charles Schumer, D-N.Y. “This should be a looming stop sign for the Republicans’ repeal effort.”

“I would hope that this would make the Republicans say ‘we can’t do this,’ ” said Sen. Patty Murray of Washington, a member of Democratic leadership.

“Twenty-four million people lose their coverage, it is total chaos to the country and I hope they pause, say ‘This is not what we should be doing,’ and move on.”

The White House has spent the past week engaged in a charm offensive aimed at bringing conservatives on board, as well as an effort to discredit the CBO before it released numbers that might cast the plan in a negative light.

“If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” White House spokesman Sean Spicer said last week.

Ryan had predicted that the CBO would forecast a loss in coverage, but he had also suggested that those affected would be exercising their choice not to buy health plans, a choice that is penalized under the Affordable Care Act.

“CBO will say, ‘Well, gosh, not as many people will get coverage,’ ” Ryan said Sunday in an appearance on CBS’ “Face the Nation.” “You know why? Because this isn’t a government mandate.”

“It’s up to people,” he said. “People are going to do what they want to do with their lives because we believe in individual freedom in this country.”

The Affordable Care Act has increased coverage by 20 million to 22 million – almost half of those through the insurance markets the law created for people who cannot get affordable coverage through a job, and the rest through an expansion of Medicaid in 31 states and the District of Columbia.