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Trumpcare would raise rates and kick tens of millions off their healthcare plans. (Photo: Craig Fildes/flickr/cc)

CBO: Trumpcare Would Strip Coverage From 23 Million, Make It Worse for the Rest

In their rush to push the American Healthcare Act through the chamber this month, Republicans did not wait for a revised report from the CBO

Deirdre Fulton

The cruel and destructive bill known as Trumpcare would increase the number of uninsured Americans by 23 million, according to the revised Congressional Budget Office (CBO) score released Wednesday afternoon. 

"What a disgrace." —Sen. Bernie Sanders

The GOP-controlled House passed the American Healthcare Act (AHCA) by just two votes earlier this month, after adding an amendment gutting protections for people with pre-existing conditions and allowing states to get waivers on the essential health benefits required by the Affordable Care Act (ACA), or Obamacare—including maternity and mental health care. In their rush to push the bill through the chamber, Republicans did not wait for a revised report from the CBO. 

That assessment, published late Wednesday afternoon, found that 14 million more people would be uninsured under Trumpcare next year. Nineteen million more would lose coverage by 2020 and 23 million by 2026.  

Furthermore, the CBO found that "people who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all—despite the additional funding that would be available under H.R. 1628 to help reduce premiums."

In other words, the "MacArthur amendment will price people with pre-existing conditions out of the market DESPITE Upton pittance," one observer wrote online, referring to changes made to the bill that made it palatable to right-wing conservatives. 

Frank Clemente, executive director of Americans for Tax Fairness, responded to the CBO score by reminding people that ultimately the Trumpcare effort is about tax cuts for the rich and should be seen as a major betrayal of the promises the president made to voters during last year's presidential campaign.

"Does the president think it's worth breaking core promises to his working-class voters in order to deliver giant bags of cash to his CEO friends?"
—Frank Clemente, Americans for Tax Fairness

"The CBO tells us that at least 23 million people will lose health coverage under the Trump-Republican health plan, including 14 million by next year - most due to $830 billion in Medicaid cuts. On top of that, the president's budget proposes cutting another $600 billion dollars from Medicaid, and it slashes Social Security Disability Insurance," Clemente noted in a statement.

"So between Trump's healthcare bill and his budget, Trump is breaking three core promises he made to his supporters over and over again: that he wouldn't cut Medicaid, that he wouldn't cut Social Security, and no one would lose their health insurance. Why? So that millionaires, billionaires, and corporations can get giant tax cuts. Does the president think it's worth breaking core promises to his working-class voters in order to deliver giant bags of cash to his CEO friends?"

Other analyses trickled out on Twitter—some pithier than others:

The office had previously said 24 million people would lose their healthcare under the previous incarnation of the legislation, for which House Speaker Paul Ryan (R-Wis.) was unable to muster sufficient support. 

Prior to the score's release, some journalists and experts predicted that Wednesday's CBO report "may look better for the GOP than it really is," as ThinkProgress editor Ian Millhiser explained in a series of tweets.

While it's possible the overall number of uninsured may fall a bit from 24 million, he wrote, "That's not necessarily a good thing, because it could mean lots of people who need insurance the most losing it."

The New York Times further explained:

Here's why: The majority of the estimated reductions in coverage come from cuts to the Medicaid program. The recent bill amendments didn't change those much. But the MacArthur Amendment, which would allow states to eliminate certain Obamacare insurance regulations, might lower the price of insurance premiums enough to prompt more Americans to sign up.

Those cheaper plans, however, are likely to cover fewer medical benefits, and may cost more for people with a history of serious illnesses. Many of our experts said the crucial changes would come not from the total number of uninsured Americans, but who they are.

The version of the bill that passed the House is likely to exclude more people who are older and sicker, while covering more who are younger and healthier. "Focus will be on premiums and on coverage, but there is a shift from sick to healthy and from good insurance to bad that needs to be emphasized as well," wrote Jonathan Gruber, a health economist at MIT.

Furthermore, others pointed out, the CBO analysis doesn't take into account the huge cuts to Medicaid—and likely losses of coverage—embedded in President Donald Trump's budget proposal, unveiled this week

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