CBO: 24 Million Would Lose Health Insurance Under GOP Bill By 2026

Tyler Durden's picture

The much anticipated CBO scoring of the American Health Care Act, aka "Trumpcare" is out, and it has concluded that millions of Americans would lose medical insurance under the republican proposal to dismantle Obamacare, dealing a potential setback to President Donald Trump's first major legislative initiative. In total, the CBO found that 52 million people would be uninsured by 2026 if the bill became law, compared to 28 million who would not have coverage that year if Obamacare remained unchanged.

Among the key highlights are the following:

  • 14 million would lose insurance by 2018, with the number risin to 24 million by 2026.
  • The budget deficit would be reduced by $337 billion over 10 years.
  • Premiums would rise by 15-20% in 2018-2019, however they would then decline by 10% than under current law by 2026.

Two House committees have already approved the legislation to dismantle Obamacare, but as reported earlier, the proposal faces opposition from not only Democrats but also medical providers including doctors and hospitals and many conservatives. The CBO report's findings could make the Republican plan a harder sell in Congress.

As Reuters adds, some Republicans worry a misfire on the Republican healthcare legislation could hobble Trump's presidency and set the stage for losses for the party in the 2018 congressional elections. Ahead of the report's release, Trump tried to rally support for the bill on Monday:  "The House bill to repeal and replace Obamacare will provide you and your fellow citizens with more choices - far more choices - at lower cost," the Republican president said at a White House meeting with people opposed to Obamacare.

The key sections from the report:

  • CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.
    • Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.
  • CBO and JCT estimate that enacting the legislation would reduce federal deficits by $337 billion over the 2017-2026 period. That total consists of $323 billion in on-budget savings and $13 billion in off-budget savings. Outlays would be reduced by $1.2 trillion over the period, and revenues would be reduced by $0.9 trillion.
  • The legislation would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter, relative to projections under current law. In 2018 and 2019, according to CBO and JCT’s estimates, average premiums for single policyholders in the nongroup market would be 15 percent to 20 percent higher than under current law, mainly because the individual mandate penalties would be eliminated, inducing fewer comparatively healthy people to sign up.

But today's estimates are somewhat worse than expected, as the Brookings Institution predicted the number losing coverage would be at most 15 million over 10 years.

The plan's arhcitect, Paul Ryan, took to twitter to react to the CBO report: "CBO report confirms it → American Health Care Act will lower premiums & improve access to quality, affordable care." He highlighted 2 sentences from his statement: "Our plan is not about forcing people to buy expensive, one-size-fits-all coverage. It is about giving people more choices and better access to a plan they want and can afford. When people have more choices, costs go down."

As the Hill notes, the long-awaited analysis from the agency is sure to shake up the debate over the measure, which is already facing sharp criticism from conservatives and many centrist Republicans.   The GOP bill repeals ObamaCare’s subsidies to buy coverage, replacing them with smaller tax credits, as well as the law’s Medicaid expansion after 2019. Both moves were expected to lead to coverage losses.

Republicans had largely expected that the CBO would show Americans losing coverage, and preemptively went on the offensive against the agency, whose director, Keith Hall, who was appointed by the GOP.  White House press secretary Sean Spicer last week argued CBO was “way off” in its ObamaCare projections.  "If you're looking to the CBO for accuracy, you're looking in the wrong place,” he said. White House budget director Mick Mulvaney, meanwhile, argued Sunday on ABC’s “This Week” that the CBO shouldn’t even try to analyze the bill. “Sometimes we ask them to do stuff they’re not capable of doing, and estimating the impact of a bill of this size probably isn’t the best use of their time,” he said.

That said, as we have shown on numerous occasions in the past, the CBO's predictive track record is simply abysmal. For an indication of that recall our post from 2013: "CBO Forecasts: Then And Now"

A few hours ago, the CBO published its most recent 10 year revised outlook for US revenue and spending: The Budget and Economic Outlook for fiscal years 2013-2023. Not surprisingly it was, as anything to ever come out of the CBO, overly optimistic. Promptly, the media latched on to the revised deficit expectations according to which the CBO now sees a budget deficit declining from 845 billion to "only" $642 billion in 2013, and dropping to $560 billion the year after. This looks at the short end: the near-term revenue benefits of recent tax increase policy which take from long-term growth (just ask Europe). The fact that the CBO also forecast the deficit proceeding to once again balloon to $895 billion by 2023 at which point the deficit difference between total spending and revenues goes asymptotic once the demographic crunch truly hits, was ignored by all.


We will ignore the underlying drivers to the CBO revision: we let readers peruse these at leisure. Instead, we will simply muse at the ridiculousness of anything called a "forecast" coming out of the CBO, and present how the "independent" economic forecasts from this office change in time.


On the chart below, the dotted lines are the CBO forecasts as a % of GDP from January 2008 for the period 2008-2018. The solid lines are the just released revised forecasts for 2013-2023.

Perhaps the most notable difference is that in 2008, the CBO was predicting that the US budget deficit would turn into a surplus in 2011. Instead ended up being an $1+ trillion deficit for that year alone. Also, in the period between 2008 and 2013, the CBO then forecast a cumulative deficit of just a few hundred billion. Instead, we ended up with deficits of over $5 trillion and, sadly, still rising.


So take anything coming out of the CBO with a very big grain of salt.


But for now, with the market hitting new highs every single day just because, the CBO is surely allowed to come up with any goalseeked numbers: it's not like anyone cares when stocks are soaring in a trance that is now completely disconnected from anything and only reliant on central bank balance sheets. And of course, we can't wait to look back in five years and laugh at this specific revised "forecast."

The CBO's full scaling of Trumpcare is below (link)

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quax's picture

Actually in his case you should make an exception. I am all for suicides that increase the herd's IQ.

IdioTsincracY's picture

Wow ... and you got all of that on your own or did you need help?!

brushhog's picture

I recommend everybody do a little research about the large studies that have been performed regarding health insurance and longevity. In most studies, health insurance had absolutely no impact on your longevity. In some, the impact is minimal ( like 1 year on average ). It is true that some people go bankrupt due to big medical bills, but its alos true that people go broke slowly due to high premiums so pick your poison.

The fact is ( and I know many of you do not want to face this reality ) but someday, you are going to die and all the insurance on the world isnt going to stop that. Its just going to happen no matter what you do. Stay healthy, eat right, live clean and you might get a bit more time.

So now that we know that, maybe we are asking the wrong questions here? Maybe instead of only discussing how we can all get insurance its time to start asking whether we should even want insurance and whether the cost ( 400-600-800-1000 dollars a month for the rest of your life ) is worth it or would that money be better spent improving the QUALITY of your life while you live?

quax's picture

And this way you will run all hospitals out of business, because in an emergency they are by law still required to treat you, insurance or not.

brushhog's picture

Hospitals have been forced to treat people for decades and they havent gone out of business. Dont worry about the hospitals. They used that bullshit story to sell Obamacare...the "free riders" were supposed to pay and keep prices down. The reality is the free riders were a tiny fraction of hospital outlays and prices went UP, not down.

quax's picture

That is because there where corporate health care plans in place. As these are hollowed out and concentrated in urban centers the medical infrastructure shrinks. That is why rural areas under under-supplied with MDs and hospitals.

brushhog's picture

Horse-shit. The free riders represented 3% of hospital costs which were passed right along. Hospitals have not suffered. People forced to buy a product that does nothing for them at insane monthly prices have suffered.

SummerSausage's picture

Deport the illegals and watch ER useage drop like a rock.

quax's picture

Because you say so, and who could argue with Indelible Scars. He's the man!

IdioTsincracY's picture



Aubiekong's picture

God I hope so, I dont have insurance now and I am tired of paying for government dependent to have health insurance.  Time to go back to if you want insurance you need to pay for it...

Mr Perspective's picture

This little nugget of biased information is brought to you by your Health Care Providers of America........

Roger Rabbit's picture

Check out the continous coverage clause. Apparently the insurance companies got these pricks to add in a penalty which is even worse than the individual mandate. Now you will pay 30% of the premium you would have been charged had you had coverage.

So we will be paying even more in the future. These dickheads have officially made this whole monstrosity 100 times worse!

SummerSausage's picture

That is for one year for those people who try to scam the system by ony buying health insurance when they're sick and dropping it when they're well.

We need some kind of penalty for those scammers.  Why shouldn't the insurance companies get it?  They're the ones required to accept all pre-existing conditions and start coverage on day 1.

If 30% for 1 year is too high, suggest a lower figure.

Otherwise, you and I who are honest and responsible take it up the butt paying for the dishonest parasites.

slightlyskeptical's picture

You plan on waiting until you get sick to buy health insurance?  Thats what it sounds like. Otherwise why would you care about that part of it or to anyone else who doesn't want to buy it?

You buy health insurance when you are young to help pay for what you use when you are old (or any time in between). 


flea's picture

Small detail: the great bulk of that number is those *voluntarily* dropping coverage since they no longer have to pay the penalty!

IdioTsincracY's picture

nope ... the report talks abot people LOSING coverage

SummerSausage's picture

There are only 8 million in the exchanges.  None of them would buy insurance AND another 6 million would drop what they have?

It's a bogus number.

quax's picture

You seem to have forgotten about the Medicare expansion that will be rolled back.

IdioTsincracY's picture

The concept of health INSURANCE is IDIOTIC

1) Car Insurance: Choices involved  buying a car or not,; buying a big car, a new car, or maybe a used car etc

2) Home Insurance: Choices involved >> buying a home or renting, buying an expensive home,  or maybe a small one etc...



The idea of private Health INSURANCE only makes sense in the minds of greedy morons


I would definitely have PRIVATE INSURANCE on bank deposits though, instead of a PUBLIC guarantee.


quesnay's picture

It's not idiotic, it's just being done incorrectly. Health insurance today acts more like a 'service agreement', rather than actual 'insurance' against unforeseen catastrophies. The system is also set up so you can't get by without health insurance. Prices are artificially inflated and health insurance companies get massive 'discounts' on that. The poor sucker that tries to pay directly will pay 5-10 times more than someone on insurance. That is a broken system.

People should pay directly for regular visists to the doctor. This would reduce load on the system, lower costs and likely create better service. Insurance should be large unforeseen catastrophies you would not be able to afford.

IdioTsincracY's picture

It is absolutely idiotic because THERE IS NO CHOICE INVOLVED,

whereas people can choose to buy a home on the shore or in an earthquake prone area.

quesnay's picture

There is no choice involved because it's not behaving acting like insurance, but like a mandatory service contract. Real insurance would be fine.

YourAverageJoe's picture

It is no one's responsibility to insure another unless they are your minor child. Period.

quesnay's picture

Okay so let me see if I understand this correctly.

- Creating Obamacare added about 14 milion previously uninsured

- Destroying Obamacare will create 24 million uninsured. 


IdioTsincracY's picture

Destroying Obamacare + GOP Idiotic Solutions adds up to 24 million uninsured ..


quesnay's picture

I think I'll remain 'skeptical' of the 24 million number.

jamesmmu's picture

24M? LOL, how many have actually signed up for obamacare?

SummerSausage's picture

Here's an idea:  let all people on Obamacare subsidies and Medicaid go to VA hospitals and all vets chose what private provider they want.


Everyone else gets to buy their insurance from a wide variety of plans sold across state lines.

Insearch's picture

Already do that in San Francisco, all the Medi-Cal go to SF General, (Zuckerberg ugh) for years

shimmy's picture

So if the CBO is horrible with their accuracy and usually is overly optimistic, the question is then are they being optimistic here and the plan will be far worse or are they being negative and it will be better than they say. Given I don't trust politicians to actually fix things, I am guessing it'll be a disaster just like obozocare is.

robertocarlos's picture

We all gotta go sometime.

Uncle Skid's picture

I'm going to take a beating for this but I have to put in my two cents.  I want the gov't out of the health care business completely.  Why can't we shock the system and go back to cash?  Start over, if you will.

gwar5's picture

Actually works great. Used to be that way. Plastic surgery market is still based on cash and costs go down, not up, due to intense competition, innovation and lack of government hand on the scales.



IdioTsincracY's picture

I instead want to take the Middle Man (insurance) out of health Care,

because when you get your Brain Cancer you will not be able

to go in and trade it for some inflamed hemorrhoids, and if you do not have enough

cash to pay for treating you BRAIN CANCER, you gonna wish the More Perfect Union

comes through and helps your a$$

Uncle Skid's picture

I have faith that a way would be devised to help people with catastrophic illnesses.  People help people all the time now as it is.  With cash forcing costs down maybe cancer treatment wouldn't be so expensive.  Does Mexico have an insurance industry?  The Philippines?

Kefeer's picture

I'd like to see a Primary Care Physician that can still fix broken bones and handy at stitching.

kalboking's picture

That's how it is in Philippines. You die in the lobby waiting for family member to come with cash. You won't even get a chair to die in unless it's paid for upfront. go live in some 3rd world shit hole i'm sure you will love it. it's exactly what you wish for.  bloody fool!!!! your daughter will give up her cherry for a mcdoos cheese burger.

TePikoElPozo's picture

as long as i don't have to pay for it

Hungrypirana's picture

5 years is more than enough time to get a damn job or get on disability or medicaid. 10 years is too long. 2 years is equitable.

kalboking's picture

I have medicaid and it rocks. They even give me a free ride 26 times a year to my appointments. my son gets therapy. i don't pay anything for meds. And a nice nurse calls me every week to make sure im doing ok. I got a sleep study this weekend. Just had my sinus and septum fixed , doc tor did wonderful job. Didn't cost me a cent. I'm very thankful. I wish everyone could have good healthcare like i receive but Muhrican are too stupid they love voting for politicans to use their  money for perpetual destruction and wars and funding Israhell which is destroying umuhrica while the israhellis get free housing and medical from the muhrican taxpayer. Sorry but i don't feel one ounce of guilt. If us gov can give money away to jews and wars they can give some to me. I would love to work but no jobs out there and i won't work like a slave with nothing to show for it. i'll get while the getting is good. don't hate the player hate the game!

Universal Healthcare is what this country needs. automation is not compatible with capitalist economy.robots don't buy shit!!!

Conservatards  value  the worth of a human by what kind of worker ant they are not by their value as people.

I am not my job , i'm not how much money i have in the bank, I'm not the car i drive. I'm not the contents of my wallet.
jamesmmu's picture

THEY DID IT AGAIN: CNN Feed Goes Dead As Obamacare Victims Begin Speaking


fatlibertarian's picture

Haha, how did the CBO rate Obamacare disaster?? 

This report is so stupid. I'm not a fan of this current Ryan plan but to be fair, they're planing on more legislation on top of this one to repeal.

Also, what would the numbers be if Obamacare stays in place and there are NO PROVIDERS IN LOTS OF STATES??

They'd have insurance but that insurance isnt worth shit.

onwisconsinbadger's picture

Is this the best you could do after 7 years of repeal and replace ? Shame on you.