Number of Uninsured Could Rise By 24M, Report Says

The American Health Care Act, the health plan proposed by House Republicans, would result in 14 million more uninsured Americans in 2018.

That was the word from the Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT), which released their report today on the of the budgetary effects of the health care reform plan.

Most of that increase would stem from repealing the penalties associated with the individual mandate, the report said. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.

Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under the current law would rise to 21 million in 2020 and then to 24 million in 2026.

The increase in the number of uninsured between 2018 and 2026 would stem in large part from changes in Medicaid enrollment, the report said. This is because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped.

Stability of the Health Insurance Market

Decisions about offering and purchasing health insurance depend on the stability of the health insurance market — that is, on having insurers participating in most areas of the country and on the likelihood of premiums’ not rising in an unsustainable spiral.

The nongroup market would probably be stable in most areas under either current law or the proposed legislation, the CBO report said.

As for the stability of the individual market, the CBO report said a number of factors would product a stable market under the proposed law. Those factors include subsidies to purchase insurance, and grants to states from the Patient and State Stability Fund, which would reduce the costs to insurers of people with high health care expenditures. Even though the new tax credits would be structured differently from the current subsidies and would generally be less generous for those receiving subsidies under current law, the other changes would, in the CBO's  view, lower average premiums enough to attract a sufficient number of relatively healthy people to stabilize the market.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].