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CBO: Straight Repeal Of Obamacare Would Increase Uninsured By 32 Million

One month after the CBO scored the now defunct Senate healthcare bill, forecasting it would increase the number of uninsured by 22 million while cutting the budget deficit by $321 billion over the next ten years, moments ago the CBO released its latest score of what a straight repeal of Obamacare would look like. In short, doing away with the Affordable Care Act, would increase the number of uninsured by 32 million by 2026, while reducing the budget deficit by $473 billion in the CBO's view.

Of note, the CBO says it "has not completed an estimate of the potential impact of the legislation on discretionary spending, which would be subject to future appropriation action."

Breaking it down, the CBO and JCT estimate that enacting the legislation would affect insurance coverage and premiums primarily in these ways:

  • The number of people who are uninsured would increase by 17 million in 2018, compared with the number under current law. That number would increase to 27 million in 2020, after the elimination of the ACA’s expansion of eligibility for Medicaid and the elimination of subsidies for insurance purchased through the marketplaces established by the ACA, and then to 32 million in 2026.
  • Average premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by roughly 25 percent—relative to projections under current law—in 2018. The increase would reach about 50 percent in 2020, and premiums would about double by 2026.

In CBO and JCT’s estimation, under this legislation, about half of the nation’s population would live in areas having no insurer participating in the nongroup market in 2020 because of downward pressure on enrollment and upward pressure on premiums. That share would continue to increase, extending to about three-quarters of the population by 2026

It also adds:

The ways in which individuals, employers, states, insurers, doctors, hospitals, and other affected parties would respond to the changes made by this legislation are all difficult to predict, so the estimates reported here are uncertain. But CBO and JCT have endeavored to develop budgetary estimates that are in the middle of the distribution of potential outcomes.

 

Pay-as-you-go procedures apply because enacting this legislation would affect direct spending and revenues. CBO and JCT estimate that enacting the legislation would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. CBO has not completed an estimate of the potential impact of the legislation on discretionary spending, which would be subject to future appropriation action.

 

CBO and JCT have reviewed the legislation and determined that it would impose no intergovernmental mandates as defined in the Unfunded Mandates Reform Act (UMRA). CBO and JCT have determined that the legislation would impose private-sector mandates as defined in UMRA. On the basis of information from JCT, CBO estimates that the aggregate cost of the mandates would exceed the annual threshold established in UMRA for private-sector mandates ($156 million in 2017, adjusted annually for inflation).

Of course, the CBO's effort is meaningless: as Monday revealed, the GOP does not even have the votes for a straight repeal, meaning that for the foreseeable future Obamacare will be the rule of the land, and as such the CBO's time is better spent calculating why it was off by 50% in its estimate of Obamacare enrollment and by how much premiums will surge over the coming years.