Here's what the CBO reported on the cost and coverage impact of the House Republicans' bill to repeal and replace the Affordable Care Act.
(All projections are in comparison to current law)
- Reduce the cumulative federal deficit by $119 billion by 2026; the prior version of the AHCA would have cut the deficit by $150 billion.
- Increase the number of uninsured by 14 million in 2018, growing to 23 million by 2026; the previous bill would have raised the number of uninsured by 24 million in 2026.
- Result in a total of 51 million uninsured in 2026, compared with 28 million under current law.
- Significantly increase the number of uninsured among people ages 50 to 64 with income under 200% of poverty.
- Lower federal Medicaid spending by $834 billion over 10 years.
- Reduce the number of people on Medicaid by 14 million in 2026, a 17% decrease.
- Save $290 billion over 10 years by replacing the ACA's premium and cost-sharing subsidies with less generous age-based premium tax credits, reducing spending from $665 billion to $375 billion.
- Increase Medicare disproportionate-share payments to hospitals by $43 billion over 10 years due to a jump in uninsured patients.
- Prompt states where half the U.S. population lives to seek waivers from the ACA's individual insurance market rules on minimum essential health benefits, use of pre-existing conditions for setting premiums and guaranteed issue.
10. Reduce individual-market premiums in states that did not seek waivers by about 4% in 2026, mainly because more younger, healthier people and fewer older, sicker people would buy coverage.
11. Create individual-market instability in states seeking fuller waivers where one-sixth of the U.S. population lives; premiums for people seeking to buy comprehensive plans would become unaffordable.
12. Reduce individual-market premiums overall while sharply increasing premiums for older, low-income people.
13. Substantially increase out-of-pocket costs for people in states that waived ACA requirements on essential health benefits, particularly for maternity, mental health and substance abuse services.
14. Prompt a few million people to use premium tax credits to buy plans that don't cover major medical costs.
15. Result in 4 million more people in employer-based health plans by 2026, mainly because employers would see the individual market as a less desirable option for their workers.
