CBO says latest GOP health care bill would cost more, not expand coverage

WASHINGTON — Changes made Monday to the Republican health care bill would add billions of dollars to the bill’s cost without increasing the number of people who would have insurance or reducing premiums, according to the nonpartisan Congressional Budget Office.

The analysis was based on the bill Republicans planned to bring to the floor Thursday, which is now being revised because it lacked enough support to pass. House Majority Leader Kevin McCarthy, R-Calif., told CNN on Thursday he hopes the House will vote Friday.

Democrats, who are united in opposition to the bill, say the CBO report shows Republicans are making the bill worse, not better.

“There’s nothing in this report that should make congressional Republicans feel more comfortable supporting this disastrous health care bill,” said Sen. Ron Wyden, D-Ore.

Like the original version, an estimated 24 million fewer people would still be without insurance in 2026 compared to how many would have coverage if the Affordable Care Act is left alone. And the most recent changes would not lower premiums.

Plus, the latest version would reduce the deficit by only $150 billion over 10 years, instead of the projected $337 billion under the original GOP bill to replace Obamacare.

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The most expensive change to the bill was expanding a tax deduction for high medical expenses. Republicans say some of that approximately $90 billion cost might be shifted to increasing the bill’s tax credits for older Americans who buy insurance on the individual market instead of getting coverage from an employer or government plan. That’s because the bill's current credits would not rise enough to offset the expected increase in premiums for older customers. They could be charged five times as much as younger customers for the same plan instead of the ACA’s limit of three times. AARP is among the influential group lobbying against the legislation.

The latest version would also cost more because the bill more quickly repeals the ACA’s taxes on the wealthy, on sectors of the health care industry and others. The taxes were imposed to help pay for the ACA's coverage expansion.

The revised version includes more Medicaid funding for the aged and disabled. Some of that cost was offset by other changes to Medicaid, including a change to New York’s Medicaid program. The bill also now gives states the option of imposing a work requirement on some Medicaid recipients and would let states chose a limited block grant for Medicaid funds in exchange for more flexibility in running their programs.

The changes were made to assuage complaints from hardline conservatives that the bill didn’t go far enough to repeal Obamacare, as well as concerns from moderate Republicans about its effect on insurance coverage. But despite the changes, Republicans lacked enough support to vote on the bill Thursday, the seventh anniversary of President Obama signing the ACA.

A look at the latest version of the GOP health care bill:

• Federal spending would be reduced $150 billion over 10 years, compared with $337 billion under the original version.
• 14 million more people would be uninsured in 2018 and 24 million more would lack coverage in 2026. This estimate is unchanged from the original bill.
• Premiums for people who buy insurance on their own instead of getting it through a government program or an employer would initially be 15% to 20% higher than under the ACA, but would be about 10 percent lower by 2026. This estimate is unchanged from the original bill. That’s because insurers would be able to offer plans covering a smaller share of health care costs; the age of those buying plans would on average be lower; the bill includes funding to help states lower premiums.