A central tenet of the Republican platform over the past eight years has been to repeal and replace Obamacare. Conservatives took issue with the prospect of the federal government forcing individuals into a healthcare market, even if it meant that far more Americans would be provided with health insurance at lower costs. As such, pledges to undo the Affordable Care Act, which was immediately coined Obamacare, were vital to Republican electoral success among constituents who favored limited government intervention. When the GOP secured both chambers of Congress in addition to the White House in November, the race was on to fulfill those lofty promises they had been making for nearly a full decade.
Last week, Republicans introduced the American Healthcare Act, or the AHCA, as their alternative to Obamacare. Several vital aspects of Obama’s plan remain in place, including the provision that allows individuals to remain on their parents’ plans until they turn 26 as well as Medicaid expansions for low-income Americans. Crucial changes pertain to the removal of the individual mandate, which forces individuals to pay a fine if they do not have health insurance as well as the removal of premium subsidies, which are to be replaced by tax credits. Democrats and Republicans alike expressed concerns over the plan from the very beginning, albeit for different reasons.
Democrats argued that the plan would increase the uninsured rate by substantial proportions and increase the cost of insurance beyond what most Americans can afford. Many conservatives, however, claimed that the plan did not go far enough to distance the future of healthcare from that provided in Obamacare. Rand Paul is at the forefront of the opposition from the Right, urging the Republican Establishment to do more to limit government interference in the healthcare sphere. Despite this widespread opposition, both sides remained unsure about the exact figures regarding coverage and costs, and the Congressional Budget Office raced to provide those estimates so that debate over the potential legislation could be more fruitful and grounded in exact numbers.
The CBO report released yesterday found that under the AHCA, the number of uninsured people would rise by 24 million within the next ten years and 15 million in just one year. According to the New York Times, “the budget office estimated that 52 million people would be uninsured in 2026 under the House Republican bill, compared with 28 million projected under current law.”
Additionally, premiums for insurance would rise by anywhere between 15 and 20 percent in the upcoming year, however they would decrease to 10% less than current rates by 2026. The ‘near-term v. long-term’ debate will inevitably be a crucial one in coming weeks as politicians make their cases for why the bill should either be passed or rejected.
Medicaid will be a critical voting point for many representatives, given the way the federal program affects constituents in their home states. The CBO report indicates that Medicaid spending and coverage will be radically decreased over the next ten years. The Times finds that “by 2026, federal Medicaid spending would be 25 percent lower under the House bill than is projected under current law, and the number of Medicaid beneficiaries would be 17 percent lower, with 14 million fewer people covered by Medicaid.” Holdout politicians from states like Ohio and Alaska will certainly use this metric as a case against the legislation.
One major victory point for the plan, however, is that it is projected to decrease the federal budget by more than $337 billion by 2026.
While the CBO is a non-partisan entity with reporting authority that is widely respected on both sides of the aisle, it was a given that the Trump administration would claim that the report misstated the costs and coverage if the report provided any projections against their interests. “We disagree strenuously with the report that was put out,” said the secretary of health and human services, Tom Price.
Do you think Republicans will adjust the legislation in response to this report? Will they have enough support to pass it as it is now?