Fourteen million fewer Americans would have health insurance next year under the Republican plan to replace the Affordable Care Act, a nonpartisan congressional analysis said on Monday, heaping pressure on US President Donald Trump to make good on his pledge to broaden coverage.
By 2026 that number would shoot up to 24 million, the US Congressional Budget Office (CBO) said, largely because the bill would undo a rule mandating people have health insurance.
It also said that the measure currently before Congress — backed by Trump and US House of Representatives Speaker Paul Ryan — would reduce the federal deficit by US$337 billion over the next decade.
Part of that reduction comes from the plan’s phase-out of the Medicaid expansion by 2020, which would save a massive US$880 billion.
Average health coverage premiums would rise 15 to 20 percent in 2018 and 2019 for individual policy holders, it said.
The projection was seen as a black eye to Trump’s repeal-and-replace plan, which already faced substantial opposition from within his own party over fears it would leave millions uninsured.
However, Politico, citing a White House document, reported that the executive’s own analysis forecast that 26 million people would lose coverage over the next decade, higher than the 24 million estimated by the budget office.
Trump and his inner circle nevertheless insist that the plan is a vast improvement over former US Barack Obama’s signature healthcare reform — dubbed Obamacare — which many Republicans say caused insurance costs to spike.
“We disagree strenuously with the report that was put out,” US Health and Human Services Secretary Tom Price said.
He said the budget office gave an incomplete picture of the Republican plan, which includes future steps to deregulate the market and allow people to buy insurance across state lines.
For Democrats, the budget office report proves that the Republican plan is a disaster.
“’Trumpcare’ would be a nightmare for the American people,” US Senate Minority Leader Chuck Schumer said, as he and House Minority Leader Nancy Pelosi urged Ryan to scrap the legislation.
However, Ryan gave an optimistic portrayal of the plan.
“Our plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford,” Ryan said.
Some conservative Republicans have argued that the proposal is too similar to Obamacare, while party moderates warn that it provides insufficient funding to help millions retain or purchase coverage.
Facing mounting concern over the plan, Trump on Monday met with “victims of Obamacare” to highlight the Republican replacement.
Asked before the budget office report was released whether he had a message to Americans who might lose coverage, Trump sounded upbeat.
“If we’re allowed to do what we want to do, it will get better. Much better,” he said.
The plan rolls back the expansion of the Medicaid healthcare program for the poor by 2020, replaces government subsidies with tax credits to help individuals buy insurance and scraps Obamacare taxes.
It preserves two popular Obamacare provisions: Insurance companies cannot refuse coverage due to pre-existing conditions, and dependents can remain on their parents’ insurance plan until 26.
Obamacare helped 20 million Americans gain coverage.
Under the new plan, premiums would begin decreasing by 2020, the budget office said, due to grants that could bump up tax credits to poor or working-class Americans and because younger people would be projected to sign up for coverage.
However, costs by 2026 would be 20 to 25 percent higher for people aged 55 to 64, the budget office said.
For the elderly poor it would be disproportionally difficult.
In 2026 under Obamacare, a 64-year-old making US$26,500 per year would pay a projected US$1,700 for coverage. Under the new plan that same person would pay US$14,600.
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