23M more uninsured under GOP health bill; CBO analysis finds older, sicker residents to be hurt

WASHINGTON - The Republican health care bill that passed the House this month would nearly double the number of people in the U.S. without health insurance over the next decade, according to a new analysis by the nonpartisan Congressional Budget Office.

The report likely will complicate GOP efforts to get the bill through the Senate, where it already faces difficult prospects.

According to the CBO, the bill would cause 23 million fewer people to have health insurance by 2026. Many additional consumers would see skimpier coverage and higher deductibles.

The report further undermines claims by President Donald Trump and House Republicans that their campaign to repeal and replace the current law - often called Obamacare - will protect all Americans' access to health care.

The House bill would be particularly harmful to older, sicker residents of states that waive key consumer protections in the current law, including the ban on insurers charging sick consumers more. The budget office estimates that about 53 million people live in states that would seek such waivers, which would be allowed under the House bill.

"Over time, it would become more difficult for less healthy people (including people with pre-existing medical conditions) in those states to purchase insurance," the report notes.

Insurance markets in states that dropped Obamacare's protections would become unstable after 2020, the budget office warned.

Health care advocates seized on the report to criticize the House bill. "The Congressional Budget Office today confirmed what we knew all along, the House plan to dismantle the Affordable Care Act is dangerous, deadly and deeply flawed," said Dr. Georges Benjamin, executive director of the American Public Health Association.

The report updates an analysis the budget office did in March of the original version of the legislation developed by House GOP leaders. Since then, Republicans made modifications tailored to win enough votes from conservative and centrist GOP lawmakers to pass the bill. It cleared the House on May 4 without any Democratic votes.

But the revisions did not fundamentally change the structure of the bill or its impact, budget analysts concluded.

The American Health Care Act, as it is called, cuts more than $1 trillion from the assistance the government gives low- and moderate-income Americans, primarily through a historic retrenchment in Medicaid, the half-century-old government health plan for the poor.

The bill also fundamentally restructures the system of insurance marketplaces created by Obamacare to guarantee health coverage to Americans, even if they are sick. Obamacare extended coverage to more than 20 million previously uninsured Americans. The law drove the nation's uninsured rate to the lowest levels ever recorded.

The Republican measure

would scale back the subsidies that the current law makes available to help people who don't get coverage through an employer afford to buy insurance. And states would be given new flexibility to scrap protections in the current law. Those include the ban on insurers charging sick people more and the requirements that all health plans cover a basic set of benefits, including mental health, prescription drugs and maternity care.

GOP leaders have argued the changes would make health insurance more affordable.

The budget office projected that average premiums for those who buy their own coverage would be lower in some states after 2020 than under Obamacare, an estimate hailed by Republicans

"It is another positive step toward keeping our promise to repeal and replace Obamacare," House Speaker Paul Ryan, R-Wis., said Wednesday.

But the decrease would be driven largely by more people having plans that cover fewer benefits and shift more costs on consumers, budget analysts wrote.

Older and poorer Americans would also see higher premiums or lose coverage altogether.

For example, under the House bill, a 64-year-old single American with an income of $26,500 a year would see his or her annual insurance bill jump from $1,700 to $13,600 in states that waive protections currently mandated by Obamacare.

By contrast, a similar consumer who is 21 would see his or her premiums decrease from $1,700 to $1,250, budget analysts projected.

noam.levey@latimes.com

Credit: By Noam N. Levey - Washington Bureau - noam.levey@latimes.com

Caption: Tom Price, secretary of Health and Human Services, applauds GOP members, including Speaker Paul Ryan, right, on May 4 after passage of a House bill to repeal Obamacare.

Cheriss May/SIPA USA