After two weeks of anticipation, the Congressional Budget Office has found that more than 24 million Americans would lose their health insurance if Republicans manage to pass the American Health Care Act, better known as Trumpcare.
Whereas the Affordable Care Act brought the nation’s uninsured rate to its lowest level in history, the CBO analysis says that 14 million would be uninsured by 2018, growing to 21 million by 2020. Including the bill’s proposed changes to Medicaid, at least 52 million Americans would lack health insurance by 2026 under the AHCA.
Anticipating the bad news, Trump surrogates have tried to discredit the CBO in recent days. Which is funny, as Donald used to rely on the CBO to criticize President Obama all the time.
Trump’s team will try to discredit the CBO assessment of its health care bill this week.
Here are 13x he used CBO estimates to attack Obama pic.twitter.com/bAEyxubnXv
— Brian Klaas (@brianklaas) March 13, 2017
Right away, Speaker of the House Paul Ryan tried to spin the report by quoting himself instead of the numbers.
— Paul Ryan (@SpeakerRyan) March 13, 2017
The CBO findings say little about the social costs or public health consequences of such a drastic change, but they would be enormous.
Devastating medical bills are the leading cause of bankruptcy in the United States — a long-term trend that put health insurance reform on the public agenda in the first place. Lack of coverage leads to worse health care outcomes, i.e. death and disability.
The CBO estimate shows premiums fall @ 2020, three reasons: 1. relatively fewer old people on plan, 2. less valuable plans, 3. reinsurance pic.twitter.com/XbJSMCbBBU
— Levi Bowles (@LeviABx) March 13, 2017
Nor did the CBO consider other consequences, such as the effect on rural hospitals as the populations they serve become the first victims of Republicans’ rush to repeal the ACA. It just so happens that these are the same people most likely to vote Republican.
CBO: Trumpcare would nearly double the uninsured rate, with a disproportionate share of that increase coming from Trump voters pic.twitter.com/eCaPnPcrRr
— Matt O’Brien (@ObsoleteDogma) March 13, 2017
Who gets hit the worst? Low-income 50-64 year olds. I seem to recall a whole lot of these folks at Trump rallies. pic.twitter.com/zBr5mx8CyK
— Benjy Sarlin (@BenjySarlin) March 13, 2017
Without a mandate to push healthy people into the market, the cost of an individual policy not tied to an employer would first go up, then decline as people avoid buying insurance until they get sick. Costs would go up faster for older people than young ones, creating the actuarial death spiral that Republicans have projected on the ACA for eight years.
In individual market, CBO is saying that premiums would go down by 10% over the decade because older people will flee the market. pic.twitter.com/AFDr7kJY9y
— Margot Sanger-Katz (@sangerkatz) March 13, 2017
The bill would reduce the deficit slightly over time, but not as much as a public option might. Furthermore, the CBO did not include any analysis of how much 52 million uninsured Americans actually cost. For example, when a population has less access to health care, pandemics spread more easily. When families lack coverage, the costs of treatment go up, not down, with strong impacts on their consumer spending and confidence.
Important to have a sense of scale on CBO numbers. $337 billion is small — GDP should sum to around $230 TRILLION over that period
— Paul Krugman (@paulkrugman) March 13, 2017
Politically, the AHCA would achieve absolutely none of the goals that Donald Trump set out in his recent speech to a joint session of Congress. Affordability would decline, access would decrease, and families would be devastated by illnesses — as if Republicans had created actual, real, not-imaginary “death panels.”
Just a reminder: Here are a few of President Trump’s promises on health care. pic.twitter.com/360JmyrsZm
— Josh Marshall (@joshtpm) March 13, 2017
Can Ryan and Senate Majority Leader Mitch McConnell ram this awful legislation down America’s throat? Many observers say no, but it never pays to underestimate just how much Republicans long to kill off poor people and transfer the wealth of average Americans upwards to the 1%.
So the real question is whether Donald Trump will continue to support a bill the public already hates, and now has even more reason to fear, or decide to throw his congressional leadership under the proverbial bus. (Don’t worry about them, they have taxpayer-provided health insurance.)
Spicer tomorrow: “Speaker Ryan’s plan …”
— David Frum (@davidfrum) March 13, 2017
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