The nonpartisan Congressional Budget Office(CBO) released its report on May 24 analyzing the expected effect of H.R. 1628, the American Health Care Act (AHCA). This report provides a prediction of the effect the bill would have on the national budget and health insurance losses. The AHCA bill was passed by Republicans in the House of Representatives on May 4 before it was given a CBO score.
The CBO score confirms advocates’ concerns that the bill would cause many to lose health insurance and would raise concerns for people with pre-existing conditions and disabilities.
Premiums will rise by 20% next year. Out-of-pocket costs will also increase.
The CBO expects premiums overall to increase by 20% in 2018. The bill allows insurers to specifically increase costs on older consumers, who could see increases of up to 800% in some markets. (source)
The bill eliminates the Affordable Care Act’s cost-sharing reductions, savings on deductibles, copays, and coinsurance that help families with the lowest incomes afford to use their insurance. In Western Pennsylvania, individuals losing CSR will see their deductibles increase by up to $3,000.
An estimated 23 million would lose health insurance by 2026.
Fourteen million would lose coverage in 2018 alone. Low-income adults ages 55 to 64 would be hit hardest, with the highest coverage losses by age group. (source)
In Pennsylvania, the bill would cause 777,000 people to lose health insurance, including over 129,000 who currently have employer-sponsored coverage.
People with pre-existing conditions would be at high risk of losing coverage.
Obamacare required insurers to cover people with pre-existing conditions without charging them a higher premium. The last-minute MacArthur Amendment would allow states to waive these consumer protections.
These waivers are expected to cause consumers with pre-existing conditions to experiences high increases in insurance costs that could make it inaccessible to them.
The CBO estimates that half the country lives in a state likely to institute these waivers. (source)
According to the CBO report, “Over time, it would become more difficult for less healthy people (including people with pre-existing medical conditions) in [waiver] states to purchase insurance because their premiums would continue to increase rapidly.”
Insurers could refuse coverage for pregnancy – and re-institute lifetime coverage limits.
Obamacare requires health plans to cover Essential Health Benefits (EHB), like prescriptions, mental health, and maternity care. Prior to Obamacare, no state legislated its own Essential Health Benefits package. This bill allows states to waive EHB requirements. Read more about this issue here.
Repealing mandatory coverage of EHBs also repeals the Obamacare’s ban on lifetime coverage limits, because the ban specifically prohibits limits on EHBs. These waivers would result in a return to the pre-Obamacare days when insurers could stop paying for vital treatment like chemotherapy. (source)
The AHCA bill slashes funding for Medicaid and premium tax credits to low-middle income families by billions of dollars.
Medicaid funding would be cut by $834 billion, while premium tax cuts would be cut by $276 billion over the next 10 years. It permanently changes how Medicaid is funded, placing limits on federal dollars contributed to the program each year. This shifts risks and costs the states. The bill ends Medicaid Expansion by eliminating enhanced funding. In Pennsylvania, over 700,000 adults have gained coverage through the program. (source)
About the Author
Cassie Narkevic is a Health Care Navigator at Consumer Health Coalition.