22M More People Would Lose Insurance Under Senate GOP Plan: Budget Office

WAShINGTON, DC —The Senate's health care plan to replace Obamacare would increase the number of uninsured people by more than 15 million people next year compared with current law, and 22 million more would be without coverage by 2026, according to an analysis released Monday by the Congressional Budget Office.

The Senate legislation would increase average cost of policies not provided by employers until 2020, compared to the costs projected under current law, and would then be less costly in subsequent years, the CBO said. Those premiums, though, would likely provide less coverage with include higher deductibles.

The Senate plan, written in closed-door sessions with no Democratic input and released Thursday, is the most recent Republican effort to fulfill a seven-year promise to replace the Affordable Care Act, which passed in 2010 and is better known as Obamacare. The House passed its version last month, and CBO estimated that the final version would increase the number of the uninsured by 23 million, similar to Senate's legislation. (For more information on this and other political stories, subscribe to the White House Patch to receive daily newsletters and breaking news alerts.)

Like the House plan, the Senate bill's cuts and alterations are built around paying for steep tax cuts of about $1 trillion for select businesses and the wealthiest 2 percent of the country's individuals. That lost tax money is paid for in both GOP versions of the bill by slashing subsidies to help poor, middle-class and older Americans pay for insurance costs. Both bills also cut Medicaid spending by hundreds of billions of dollars.

Because much of the billion Medicaid cuts in the Senate bill would take place after 2026, which is where CBO cuts of its projection, many more people will be left uninsured under the new legislation beyond that point. Medicaid insures one in five Americans, most of them poor, middle-class, disabled or elderly.

"Americans need relief from the failed Obamacare law," said Senate Majority Leader Mitch McConnell Monday in a statement. He led the effort in his chamber to craft the bill, excluding even most other Republicans from the process.

See also: How To Call Your Senators About The Republican Health Care Bill

He continued: "The American people need better care now, and this legislation includes the necessary tools to provide it."

Shortly after the report was published, the United State Conference of Catholic Bishops released a statement criticizing the legislation.

"The loss of affordable access for millions of people is simply unacceptable," the statement said. "These are real families who need and deserve health care. We pray the Senate will work in an open and unified way to keep the good aspects of the current health care proposals, to add missing elements where needed, and to not place our sisters and brothers who struggle every day into so great a peril on so basic a right."

The CBO projects $321 billion in deficit reduction under the Senate legislation, savings that Republicans hope to use to help finance tax cuts later in the year.

But much of the financial impact of the bill will be felt by people buying health insurance on the individual market.

The millions who would lose their insurance, though, and the period of increasingly expensive premiums comes with more bad news from the budget office for consumers: their out-of-pocket costs would increase for most consumers under the Senate plan even after increases in the the price of premiums begin to slow. Deductibles for a mid-range plan average around $3,600, currently; the report projects that average deductibles will be closer to $6,000 under the Senate bill.

For many people, the report says, this will make the plans virtually worthless, and they'll decide not to buy insurance at all.

"Insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law," the report says. "Some enrollees could see large increases in out-of-pocket spending because annual or lifetime limits would be allowed."

President Trump previously said that his health care plan would lower deductibles, would not cut Medicaid and would cover everyone. He has been a vocal supportive of both the House and Senate bills, though,which do not come close to fulfilling his promises.

Because the Senate bill allows states to roll back much of Obamacare's insurance regulations, insurers may choose to drop certain forms of coverage, such as maternity care, mental health treatment, rehabilitative care and pricy prescription drugs.

In these regions, premiums may come down significantly in price. The cost, however, would be that these plans would provide much less support for people when they really need it when, for example, they are pregnant, have a mental health crisis or need treatment for addiction.

Before the CBO score had been released, the health insurer Anthem released a statement in support of the bill, breaking with most other insurance companies.

"We believe the Senate discussion draft will markedly improve the stability of the individual market and moderate premium increases,” it said. "We are committed to working with our government partners now and into the future to navigate the challenges the current bill proposes to the Medicaid program knowing how important it is to achieve the necessary funding and access to healthcare services and supports are for the individuals and families who rely on them.”

CBO scores are not unassailable; the Trump administration has frequently pointed out that office overestimated the number of people who would be insured after Obamacare passed.

"The CBO has consistently proven it cannot accurately predict how healthcare legislation will impact insurance coverage," the White House said in a statement. "We know the facts. To date, we have seen average individual market premiums more than double and insurers across the country opting out of healthcare exchanges. As more and more people continue to lose coverage and face fewer healthcare choices, President Trump is committed to repealing and replacing Obamacare, which has failed the American people for far too long."

However, the despite the White House's protestations, the CBO has a recognized history of nonpartisanship, and its current director, Keith Hall, was chosen by Republican lawmakers to lead the agency.

"Despite the uncertainty, the direction of certain effects of this legislation is clear," the CBO writes in the report. "For example, the amount of federal revenues collected and the amount of spending on Medicaid would almost surely both be lower than under current law. And the number of uninsured people under this legislation would almost surely be greater than under current law."

Read the full report.

Photo by Spencer Platt/Getty Images