House healthcare bill would end coverage for 23 million by 2026

About 23 million Americans would losehealthcarecoverage over the next nine years if the bill recently passed by the U.S. House of Representatives were to become law, according to the nonpartisan Congressional Budget Office (CBO).

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The CBO, in partnership with the Joint Committee on Taxation, released its analysis of the House bill-the American Health Care Act of 2017 (AHCA)-late Wednesday. Among its findings:

·      In 2018, 14 million fewer people would have healthcare insurance than under current law, and that number would increase to 19 million in 2020 and 23 million by 2026.

·      Premiums for coverage purchased on the individual market would be about 25% higher in 2019 compared with the current law. After 2020, average premiums would depend significantly on the state in which coverage was purchased.

·      About eight million fewer people would get healthcare coverage through the non-group market in 2018 compared with current law. That number would rise to 10 million by 2020, but drop to roughly six million by 2026.

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·      About 14 million fewer people would be enrolled in Medicaid by 2026 compared with expected enrollment under current law.

·      The federal deficit would decrease by approximately $119 billion between 2017 and 2026 as a result of changes in spending and taxation included in the AHCA.

The House narrowly passed the bill earlier this month, before the CBO had “scored” it. In March, a vote on a slightly different version of the bill was cancelled after it became clear the legislation would not pass. House leadership and President Trump, say passage of the AHCA fulfills a campaign pledge to repeal and replace the Affordable Care Act.

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The uncertainty about premiums beyond 2019 results from the provision in the AHCA that allows states to apply for waivers from the requirement that policies sold in the individual markets include certain “essential health benefits,” such as maternity coverage. States would also be allowed to apply for waivers that would allow insurance companies to base premiums on an individual’s health status-provided the person had maintained continuous coverage-rather than community rating.

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The CBO estimates that about half the country’s population lives in states that would not request any waivers, and that premiums for residents of those states would be about 4% lower in 2026 than under current law.

About one-third of the population lives in states the CBO expects to make “moderate” changes in healthcare insurance regulations. Premiums for residents of these states would be about 20% lower than under current law, the CBO says, “primarily because, on average, insurance policies would provide fewer benefits.”

The remaining one-sixth of the population lives in states the CBO predicts would ask for waivers from both essential health benefits and community rating requirements. In these states, it says, premiums would vary depending on the individual’s health status and the types of benefits included in a policy. But over time, premiums would rise rapidly for less-healthy individuals and those with preexisting conditions, making it more difficult for them to purchase coverage.

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The U.S. Senate began crafting its own healthcare reform bill soon after the House passed the AHCA. Whatever comes out of the Senate is expected to differ significantly from the AHCA. If that were to happen, the two chambers would have to agree on and pass an identical bill before it could become law.