- Alex Wong/Getty Images
The Congressional Budget
Office on Monday released
its analysis of the Senate Republican healthcare bill,
projecting significant coverage losses both immediately and over
the next decade if the legislation were to become law.
The CBO projected that 22 million fewer people would have
coverage under the bill, the Better Care Reconciliation Act, in
2026 than under the current healthcare system.
That is slightly below the CBO’s projection last month that
23 million fewer people would have coverage under House
Republicans’ American Health Care Act. But the Senate bill would
still push the number of uninsured up to 49 million in 2026
versus about 28 million under current law, the CBO said.
The budget office also projected the bill would reduce the
federal deficit by $321 billion between 2017 and 2026 – more than
the projected $119 billion in savings under the House bill –
meaning it can qualify for passage under Senate rules.
The savings would be possible with an $862 billion cut in
spending over that time, the CBO said, while revenue would
decline by about $541 billion from tax cuts.
Moderate GOP senators who have expressed concerns over large
coverage losses may not be reassured by the score. Sen. Susan
Collins of Maine, a key swing vote, said Thursday that coverage
losses of the size estimated by the CBO score were not
“I cannot support a bill that’s going to result in tens of
millions of people losing their health insurance,”
Senate Majority Leader Mitch McConnell can lose only two members
for the bill to pass.
Five Republicans publicly came out against the bill in its
Here are a few other key findings from the CBO:
- Premiums would increase in 2018 and 2019 compared with
the current baseline but decline after. According to
the CBO, premiums would be 20% more than under current law in
2018 and 10% more in 2019. In 2020 and beyond, the change in
the risk pool, with older and poorer Americans most likely
priced out, would bring these premiums down.
Deductibles and out-of-pocket costs would increase
substantially. The benchmark plan on the individual
insurance market would have an actuarial value of 58%, meaning
insurance would be obligated to cover 58% of total costs. That
is down from the current 70% benchmark value. According to the
CBO, that would open the door for higher deductibles and
“Under current law for a single policyholder in 2017, the
average deductible (for medical and drug expenses combined) is
about $6,000 for a bronze plan and $3,600 for a silver plan,”
the CBO said, adding that it and the Joint Committee on
Taxation “expect that the benchmark plans under this
legislation would have high deductibles similar to those for
the bronze plans offered under current law.”
The newly added waiting-period provision would lead
slightly more people to maintain coverage. The
provision, added to the bill on Monday, would make anyone who
did not maintain coverage in the prior year wait six months
before being able to access coverage benefits if they signed up
the following year.
“Imposing that waiting period would, CBO and JCT expect,
slightly increase the number of people with insurance, on net,
throughout the 2018-2026 period – but not in 2019, when the
incentives to obtain coverage would be weak because premiums
would be relatively high,” the CBO said.
Individual insurance markets would remain
stable. The last version of the House healthcare bill
would have made unstable the markets for people purchasing
insurance not through an insurer or government program like
Medicaid, the CBO said, but the Senate bill would not
destabilize these markets.