By Meg Wagner
The ‘victims’ of the ‘imploding’ ACA
The upcoming report from the Congressional Budget Office (CBO) on the Republican plan to repeal Obamacare will likely show that fewer Americans will be insured under the new Affordable Health Care Act (AHCA), also known as “Trumpcare” — but the GOP braced for the nonpartisan analysis by doubling down on its longstanding anti-Obamacare rhetoric.
On Sunday, House Speaker Paul Ryan (R-Wis.) admitted that the CBO analysis (expected to be released as early as Monday) will probably show that fewer people will be insured under the new plan. However, he touted the fact as a positive sign, saying that the bill removes the Obamacare insurance mandate — which financially penalized anyone who wasn’t covered— and gives customers the choice to forego coverage entirely. “We’re not going to make an American do what they don’t want to do,” he said.
And President Donald Trump held a meeting at the White House on Tuesday morning with so-called “victims” of the 2010 Affordable Care Act (ACA), during which he listened to health care professionals and patients who claimed that the law failed them.
“Things are gonna be very bad this year for the people with Obamacare,” Trump told the group Monday, adding that the law is “imploding” and that 2017 will be “the worst year,” without providing an explanation of what that meant.
When drafts of the Republicans’ plan to repeal Obamacare first circulated in January, the CBO estimated that 18 million people would lose health insurance in the first year if major portions of the ACA were repealed. That report was based on a 2016 bill that would have repealed the mandate and ended health care subsidies — one that that former President Barack Obama ultimately vetoed.
The CBO’s new report on the final version of the AHCA, which Republicans unveiled last week, is expected to again show that many Americans will lose coverage. But the figures could change since the new bill doesn’t simply repeal Obamacare subsidies; it instead replaces them with a tax credit system.
More tax credits and less Medicaid
Overhauling Obamacare was central to Trump’s campaign platform. Just hours after he took office on Jan. 20, Trump issued an executive order scaling back parts of the ACA, allowing federal agencies to change and waive parts of the law they deemed financially burdensome (although it gave no specifics about which ones) while Republican lawmakers worked on a plan to repeal and replace the law. On March 6, they unveiled the American Health Care Act.
The proposed law still provides federal funds for health care expenses, but changes the way that money is doled out. Where Obamacare provided large federal subsidies to low- and middle-income Americans to purchase insurance, the new plan gives out age-based tax credits, with older Americans getting larger payouts.
More people would likely be eligible for the tax breaks, but they’d likely be less generous than the Obamacare subsidies. The new credits would max out at $4,000 while the average ACA subsidy is currently $386 per month in 2017, or about $4,600 per year.
The new bill would also phase out expanded Medicaid programs, which provided about 11 million low-income Americans with insurance.
Attacking the CBO amid growing resistance against the bill
In advance of the CBO’s findings, White House officials have begun questioning the accuracy of the nonpartisan group in an attempt to demean the content of its analysis.
On Sunday, Gary Cohn — the director of the White House National Economic Council who once worked as the head of Goldman Sachs — claimed that the number-crunching department overestimated how many Americans would be insured under Obamacare.
“In the past, the CBO score has really been meaningless,” he said during a Sunday interview with Fox News.
A March 2010 CBO report indicated that by 2016, 21 million people would purchase health insurance through exchanges created under the ACA. But by the end of last year, 11.5 million people had signed up for coverage — 9.5 million less than what the CBO forecast. The office later altered its prediction to a more accurate 13 million, noting that more people chose to circumvent the marketplaces by buying plans directly or through their employers than they expected. Additionally, the group accurately predicted the total number of people who would gain coverage (since it underestimated how many people would get insurance through Medicaid) and has correctly forecast premium increases.
The new CBO report will likely add to the growing resistance against the AHCA. Democrats have already claimed that it will deny coverage to millions of Americans who became insured thanks to Obamacare, and the new analysis will likely reinforce that talking point.
And while the new legislation was drafted by House Republicans, not all conservatives are happy with it. Right-wing lawmakers and advocacy groups have complained that the bill doesn’t repeal the ACA in full and suggesting that any federal spending on health care is too much like Obamacare.
The House Freedom Caucus, a conservative faction of Congress that has already voiced opposition to the bill, is expected to meet with White House officials Tuesday to discuss their concerns with the legislation.