CBO Prediction on GOP Insurance Plan: 14 Million Uninsured Next Year, 24 Million By 2026

Around 14 million fewer people will be insured in 2018 if Congress passes the Republican health care bill, pushed by both Speaker of the House Paul Ryan and President Trump, according to the Congressional Budget Office's evaluation of the proposed law published Monday.

That number jumps to 24 million by 2026 — though, it should be noted, predictions further into the future are less likely to be accurate.

CBO also projects that the bill would reduce the federal deficit by $337 billion over the next 10 years.

Because the GOP bill rolls back the mandate for individuals to buy health insurance, many expected the CBO score to predict a rising number of uninsured people. But it's not just the roll back of the mandate leading to these increases: The CBO says that the GOP's changes to the current health care subsidies, first enacted by Obamacare, would also induce customers to drop out of the market.

And after 2020, the GOP plan ends Medicaid expansion, which further reduces the number of insured people.

By 2026, the CBO predicts that 52 million Americans would be uninsured under the GOP's plan, rather than the 28 million the country would have under current law.

Having fewer people in the individual health insurance market almost certainly means one thing: rising premiums. This is because the people most likely to drop out of the market are younger and healthier. As the pool of people insured on the individual market gets sicker and older, the cost of health care premiums inevitably rises.

According to the CBO, in 2018 and 2019, the GOP's proposed law would mean that, "Average premiums for single policyholders in the nongroup market would be 15 percent to 20 percent higher than under current law."

One of the most frequent complaints about Obamacare, from both critical politicians and individual policyholders, is that the premiums are already too high. The CBO is saying that the Republican plan would make that problem significantly worse.

However, after 2020, the CBO predicts the premiums to grow more slowly. By 2026, it estimates that average premiums in the individual market would be 10 percent less than what they would be under current law.

In a statement, Ryan said the report confirms that the GOP plan would lower premiums.

"When people have more choices, costs go down," he said. "That's what this report shows."

This, though, is very misleading. As stated, individual market premiums would likely spike in the near term. Over the longer term, premiums would rise somewhat more slowly, according to the report.

But causing premiums to "rise more slowly" is not the same as "lowering premiums" — and many already feel that their premiums are too high. If the bill were to pass, and these predictions are accurate, premiums would spike ahead of the coming midterm elections and then as the 2020 presidential race gets started — creating very rocky political terrain for those who would defend the law.

Ryan also obliquely acknowledged the report's estimates of the uninsurance rate, saying, "I recognize and appreciate concerns about making sure people have access to coverage."

Despite Ryan's touting of some of the report's findings, Health and Human Services Secretary Tom Price said to reporters,"We disagree strenuously with the report that was put out."

He said that the plan will "cover more individuals at a lower cost." Regarding the projections that 14 million people could soon become uninsured, he said, "It's just not believable."

The different responses from Ryan and Price reflect divisions we've already seen between the administration and the speaker. Since the release of the plan, Ryan has suggested that more uninsured Americans is acceptable to him, because this result would be an indication of greater choice and freedom.

Price, who speaks more directly for the administration and thus for the president, has repeatedly dismissed speculation that people would lose coverage under the bill. Since Trump has promised that his health care plan would cover everybody, it's not surprising that the administration is insisting that its plan would not cause fewer people to be insured.

For what it's worth, the director of the nonpartisan CBO, Keith Hall, was appointed by Republicans. In fact, Price wrote a letter to then-Speaker John Boehner in 2015 to recommending Hall for the job.

House Minority Leader and California Democrat Nancy Pelosi spoke to reporters about the release of the report.

"I hope that they would pull the bill. It's really the only decent thing to do," she said. "Numbers are important. They see the numbers; they should know how that transfers into people's lives."

Speaking about Republican representatives who might vote for the bill, she said: "How can they look their constituents in the eye when they say to them, '24 million of you are no longer going to have coverage. And those of you who do have it will have less in terms of coverage at more cost to you'?"

Senate Minority Leader Chuck Schumer, the New York Democrat, defended the CBO's credibility.

"CBO is virtually unassailable," he said. "Everyone, Democrats and Republicans, whether it be George Bush, Barack Obama, or anyone else, has gone along with CBO."

CBO estimates, of course, are not gospel, and the agency has made incorrect predictions in the past. But the office has a relatively strong reputation for being nonpartisan and for carrying out its work in good faith.

Two house committees have already approved the bill to move forward to a vote, and the bill will be before another committee this week. The results of this report are certain to influence the debate.

Read the full CBO report>>

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