HR 1628 - The CBO Report Is Out

The Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) has issued its report on HR1628, (a.k.a. the "American Health Care Act of 2017").

And this is what the CBO said:

CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under H.R. 1628 than under current law. The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026. In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law. Under the legislation, a few million of those people would use tax credits to purchase policies that would not cover major medical risks.

23 million Americans without health care coverage.  But, Slate adds:

On the bright side, some people would get cheaper coverage with fewer benefits—which is great for young, healthy men in particular—and gutting Medicaid and reducing spending on insurance subsidies would cut the deficit by about $119 billion. So there's that.

But details, details. How would this work?  CNN reports:

The legislation that ultimately passed would allow states to waive two key Obamacare protections for those with pre-existing conditions. Insurers in these states would be allowed to charge higher premiums to those with pre-existing conditions if they let their coverage lapse. Carriers would also be allowed to offer skimpier plans that would have lower premiums, but not cover as many benefits. But lawmakers also allocated additional money to a stability fund to help states cover high-cost enrollees.

That last sentence is the measly $8 billion in the Upton Amendment.  About that $8 billion, Slate says:

It makes short work of the Upton Amendment, writing that though it pushes down costs as intended, the effect “would be small because the funding would not be sufficient to substantially reduce the large increases in premiums for high-cost enrollees.” In other words, it's barely worth talking about.

 And on the MacArthur Amendment, Slate says:

The number-crunchers spend much more time on the MacArthur Amendment, since it could fundamentally reshape how insurance is sold in some states. The report estimates that half of the country would live in places where lawmakers would choose to keep all of Obamacare's rules. There, premiums would be a mere 4 percent lower by 2024, largely because the AHCA's basic structure would tend to price older Americans out of the insurance market and draw in younger customers, who pay less for their coverage. Another third live in states that would nix many of the essential health benefits Obamacare now guarantees, such as maternity and mental health care. Those places would see a 20 percent drop in premiums by 2026 compared to current law, “primarily because, on average, insurance policies would provide fewer benefits.” However, not everyone would benefit equally. “The reductions for younger people would be substantially larger and those for older people substantially smaller,” the CBO nots. People who needed more extensive medical care would also have to pay more out of pocket.

Finally, the CBO thinks that about one in six Americans live in states that would drop both the essential health benefit and community rating rules. This would create significantly cheaper insurance for people with few health care needs, while leaving the sick to pay “extremely high premiums” that would “rapidly rise” over time. Technically, insurers would still be required to sell to people with pre-existing conditions, and could only raise prices for those who have gaps in their insurance market. But for reasons previously spelled out well by analysts at Brookings, the CBO still thinks the markets in those states would bifurcate—one with cheap insurance for the healthy, and another with wildly expensive coverage for the ill.

So for those who don't need insurance, it's cheaper and easier.  For those who do, it's more expensive (perhaps too expensive) to keep - and you're on your own.

And this is what all these Pennsylvania Republicans voted for:

• Mike Kelly - Pennsylvania 3rd Congressional District
• Bill Schuster - Pennsylvania 9th Congressional District
• Keith Rothfus - Pennsylvania 12th Congressional District
• Tim Murphy - Pennsylvania 18th Congressional District

I wonder how many of their constituents they're screwing over in order for their wealthier, healthier voters to save a few bucks?