Congress' analyst: Millions to lose coverage under GOP bill

WASHINGTON (AP) --Congress remains divided over how to interpret the non-partisan Congressional Budget Office report analyzing the House Republican's health care plan.

On the plus side for Republicans, the budget office said the GOP measure would reduce federal deficits by $337 billion over the coming decade, largely by cutting federal funding for the Medicaid program for low-income Americans and eliminating subsidies that the 2010 Affordable Care Act provides to millions of people who buy coverage.

The GOP legislation would push premiums upward by an average of 15 to 20 percent compared to current law, but premiums would move lower after that. By 2026, average premiums for individuals would be 10 percent lower than under former President Obama's health care law.

Democrats blasted the GOP plan, however, pointing to the CBO estimate that 14 million Americans would lose insurance coverage in 2018 if the House Republican plan passes "as is", That number would increase to 24 million more uninsured by 2026 compared to the current law. The estimates would undercut President Donald Trump's campaign claim to make sure no one loses their insurance and his January comment about "insurance for everybody." He has since stated a less expansive goal -- to "increase access" advanced by House Speaker Paul Ryan and other Republicans.

"We're negotiating with everybody.  It's a big, fat beautiful negotiation, and hopefully we'll come up with something that's gonna be really terrific," President Trump said Monday.

Democrats said the increase in uninsured is unacceptable and challenged Republicans.

"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,'" said House Minority Leader Nancy Pelosi of California, "I hope they would pull the bill. It's really the only decent thing to do."

House Speaker Paul Ryan said the reason for the increase in uninsured is because with no mandate, people would be free to opt out.

'If we're not gonna force people to buy something they don't want to buy, they won't buy it.  And that's kind of obvious," Ryan said, adding that the CBO report was welcome and exceeded his expectations.

The report, however, deals a stiff blow to a GOP drive already under fire from both parties and large segments of the medical industry.

"The average premium goes down over time because there's a shift in who's covered. You're pushing out some of the older people, poorer people who may have cost more and had more health problems and bringing in more young, affluent people," said Ken Jacobs, Chair of the UC Berkeley Center for Labor.

Jacobs also says overall younger healthy adults would pay less, while older people would pay more.

"The people who gain the most are upper income and under 30," Jacobs said, while adding those who don't qualify for Medicare would lose, "that 50-64 range are the ones who will see their costs go up significantly."

The Congressional Budget Office report undercuts a central argument President Donald Trump and Republicans have cited for swiftly rolling back the 2010 health care overhaul: that the insurance markets created under that statute are "a disaster" and about to implode. The congressional experts said that largely would not be the case, that the market for individual policies "would probably be stable in most areas under either current law or the (GOP) legislation."
 
Health secretary Tom Price said the administration rejects the CBO report.

"We believe that the plan that we're putting in place is going to insure more individuals than currently are insured. So we think that CBO simply has it wrong," said Price, adding that the report does not include yet-to-be introduced GOP legislation and regulatory changes that the Trump administration plans for the future.

Still, the budget office's estimates provide a detailed, credible appraisal of the Republican effort to unravel former President Barack Obama's 2010 overhaul. The office has a four-decade history of even-handedness and is currently headed by an appointee recommended by Price when he was a congressman. Trump has repeatedly attacked the agency's credibility, citing its significant underestimate of the number of people who would buy insurance on state and federal exchanges under "Obamacare."
 
The GOP bill would obliterate the tax penalties Obama's law imposes on people who don't buy coverage, and it would eliminate the federal subsidies reflecting peoples' income and premium costs for millions.

It instead would provide tax credits based largely on recipients' ages, let insurers charge more for older people and boost premiums for those who let coverage lapse. It would phase out Obama's expansion of Medicaid to 11 million additional low earners, cap federal spending for the entire program, repeal taxes the statute imposes and halt federal payments to Planned Parenthood for a year.
 
The American Medical Association, which has opposed the Republican bill because it would reduce coverage, said the report shows the legislation would cause "unacceptable" consequences. "

Some of the GOP's most conservative members still oppose the House Republicans' plan.

"Do not walk the plank for a bill that cannot pass the Senate and then have to face the consequences of that vote," warned Republican Senator Tom Cotton of Arkansas.