The worse-than-expected healthcare analysis released Monday by the Congressional Budget Office (CBO) has Republicans on the defensive, the White House dodging campaign promises, and the resistance movement reenergized to fight back.
According to the CBO, the GOP's healthcare plan would cause 24 million Americans to lose health coverage over the next 10 years, raise premiums for millions more, and afford a massive tax cut to the rich.
"The plan, the CBO concludes, would take more than $1 trillion away from programs targeting poor and middle-class families, to fund an $883 billion tax cut targeted at the wealthy," Dylan Matthews wrote at Vox. "It is upward income redistribution of a truly massive scale."
House Speaker Paul Ryan (R-Wis.) tried to put a positive spin on the CBO's "devastating" report even as interest groups, Senate Republicans, and right-wing conservatives voiced increasing skepticism over the American Healthcare Act (AHCA), recently dubbed "TrumpCare."
The Hill reported:
Ryan went on Fox News soon after the report was released and said he was "encouraged" by the findings. He pointed to items like the deficit reduction and decrease in premiums that the report found, while seeking to downplay the coverage losses.
Much of the change in the uninsured rate, Ryan said, would simply be due to people choosing not to buy coverage once the mandate for having coverage is repealed.
"What I’m encouraged [by] is, once our reforms kick in, what the CBO is telling us is, it's going to lower premiums—it will lower premiums 10 percent. It stabilizes the market. It's a $1.2 trillion spending cut, an $883 billion tax cut, and $337 billion in deficit reduction," Ryan said.
"So of course the CBO is going to say if you're not going to force people to buy something they don't want to buy, they won't buy it."
However, as the Center on Budget and Policy Priorities explained:
The drop in average premiums occurs partly because older adults are likelier to lose coverage because they can no longer afford it, removing them from the average. Average premiums would rise 20 to 25 percent for 64-year-olds, while dropping 20 to 25 percent for 21-year-olds, CBO estimates. Unsurprisingly, older people would be the most likely to find individual market coverage unaffordable. "A larger share of enrollees in the non-group market," CBO concludes, "would be younger people and a smaller share would be older people." That fact alone will reduce average premiums because older people have higher health costs and premiums than younger people. In other words, if a 64-year-old drops out of the market altogether because he can't afford to pay for insurance, that lowers the average premium in the individual market since he no longer appears in the calculations.
Many others will go without coverage due to sweeping cuts to Medicaid. President Donald Trump vowed multiple times on the campaign trail not to cut the program, but the CBO analysis shows AHCA would see Trump "break his promise—by a mile," as NBC News put it. TrumpCare would slash $880 billion in federal funds from Medicaid in the next 10 years, leaving 14 million fewer people without coverage by 2026.
(It's worth noting that Seema Verma, Trump's "extremist" nominee to head the Centers for Medicaid and Medicare Services, was confirmed by the Senate on Monday. As a healthcare consultant, Verma was instrumental in multiple state efforts to restrict Medicaid coverage.)
Furthermore, NBC noted:
[Medicaid cuts] could have repercussions for another Trump promise to "give people struggling with addiction access to the help they need" which he made in a speech on the topic last October.
A number of lawmakers, including key Republicans, have expressed concern that cuts and changes to Medicaid could affect patients who receive substance abuse treatment through the program.
Health and Human Services Secretary Tom Price was asked to defend the plan in light of other Trump campaign rhetoric on Tuesday morning, when "Today" show hosts asked him about the president's pledge to ensure coverage for every American.
"Are you saying no one is going to lose coverage under this plan?" NBC's Savannah Guthrie asked Price. "Because that's what the president promised."
"What we're saying is that the current system has failed," was Price's non-answer. "You got one-third of the counties in this nation that are only offering one coverage policy. Five states, only one coverage policy. Premiums going up, deductibles going up. The fact is that the current system has failed."
— TODAY (@TODAYshow) March 14, 2017
And so the battle to defend healthcare and defeat TrumpCare continues, with Tuesday's "Resist Trump" actions geared toward repairing, not repealing, the Affordable Care Act, and "stakeouts to save healthcare" planned nationwide for Thursday and Friday.