White House officials and Republican congressional leaders promised that Americans with health insurance under the Affordable Care Act would not lose that coverage under a Republican-crafted replacement. That promise was proven utterly untrue Monday.
Fourteen million fewer people would be insured under the Republican-crafted American Health Care Act in its first year, the nonpartisan Congressional Budget Office said in a review released Monday. By 2026, 24 million fewer people will have health insurance than if the Affordable Care Act remained in place, the CBO concluded. This is because people would forgo insurance because of higher premiums under the Republican plan and its elimination of penalties for not having insurance. Changes to Medicaid in the bill would further reduce the number of Americans with health insurance.
This would nearly double the number of uninsured Americans; 52 million people would lack insurance in 2026 compared with 28 million if the ACA remained in place.
Enacting the American Health Care Act would reduce the federal deficit by $337 billion over the next 10 years, the CBO said. The financial savings would come from eliminating the ACA’s subsidies and changes made to Medicaid. But if Republican leaders, who cheered this part of the analysis, were serious about reducing the deficit, they’d remove the hundreds of billions of dollars in tax breaks unrelated to health care that they tucked into their ACA “fix.”
The American Health Care Act would hit rural states with older populations, like Maine, the hardest. The ACA offered subsidies, based on income, to help people afford health insurance premiums. The Republican plan offers tax credits based on age, with older Americans getting larger credits, even at fairly high incomes.
A 27-year-old earning $30,000 a year and living in Aroostook County would see a nearly $1,600 reduction in tax credits under the Republican plan compared with the ACA, according to an analysis by the Kaiser Family Foundation. A 60-year-old Aroostook County resident earning the same income would receive $9,210 less in tax credits under the Republican plan than under the ACA. However, if that 60-year-old earned $75,000 a year, his tax credit would be $4,000 higher under the Republican plan.
Despite these disparities in his rural district, Republican Rep. Bruce Poliquin, who has voted numerous times to replace the Affordable Care Act, has been supportive of the plan crafted by his House colleagues. “This new plan will bring much needed health insurance relief to the American People while keeping the promises made to them,” he said in a statement last week. After the CBO analysis, he said the bill was “just the beginning.”
Republican Sen. Susan Collins, on the other hand, said the CBO numbers were “cause for alarm.”
“The CBO estimate that millions of Americans could lose their health insurance coverage if the House bill were to become law is cause for alarm,” she said in a statement Monday. She urged House backers of the plan to go back to the drawing board. She and Louisiana Sen. Bill Cassidy have introduced a bill that would allow states to create their own alternatives to the ACA. It is far from perfect, but is a much better framework than the House Republican plan, which would also reduce access to opiate treatment, reduce public health funding and end funding for Planned Parenthood.
On the Senate floor last month, Sen. Angus King quoted studies that show that, for every 1 million people without health insurance, 1,000 will die primarily because they’re uninsured. Combining this calculation with the CBO analysis, 14,000 people will die next year without insurance under the Republican-backed plan. That would rise to 24,000 deaths in a decade.
“Look around at your friends, your neighbors, your family and your loved ones. This bill is going to cost someone you know their health insurance,” King said in a statement Monday.
“I hope this report will be a wake-up call to those who are breathlessly pushing this misguided proposal forward, and I make a plea to them — on behalf of the tens of millions of Americans who will be hurt by this bill — abandon this approach and let’s work together to fix the Affordable Care Act.”
Seeking to reduce the deficit is a worthwhile goal. Doing it by taking health insurance away from millions of Americans to increase tax breaks for the wealthy is not only the wrong approach, it is heartless.