That's the cryptic analysis by the
The CBO's score of the proposal, which was released Monday, offers a pretty glum assessment of Ryan's American Health Care Act -- a complete reversal of all the enrollment gains of Obamacare over the last six years. According to the CBO's 38-page report, 14 million more Americans would be without insurance next year than would have it under Obamacare; before a decade was out, that number would grow to 24 million, bringing the total number of uninsured Americans to 52 million.
But for most Americans, talk of winners and losers is misleading. Insurance only really works when everybody participates. The healthy subsidize the sick; the wealthy subsidize the poor. The upshot is a healthier society in which everybody is able to access medical care, reducing costs all around. When the young and healthy opt out of getting coverage, that drives up costs, preventing the poor and the sick from accessing insurance. But the "charity care," provided to them by hospitals that has been estimated at about
Obamacare's individual mandate sought to address the phenomenon of free riders by requiring everybody to buy health insurance. The provision in Ryan's plan that is intended to function as a kind of individual mandate has been universally derided as a weak substitute. This provision, which is designed to incentivize continuous coverage by letting insurers apply a 30 percent surcharge when a person buys insurance after they are already sick will have the effect of driving up insurance costs, not decreasing them.
The knives are already out for Ryan's plan. Hospitals, doctors and health associations were among its first critics, all noting that the plan does nothing to improve access to care, but instead makes it worse than it has been under Obamacare. And it's been attacked by both centrist and hard-right
Many noted that the new plan resembled a "lite" version of the ACA, its sum total a little more than a ragbag tatterdemalion of shrunken Obamacare patches that will accomplish far less than Obamacare has, yet still result in increased premiums, higher deductibles and co-pays, the outcome of which would be far fewer enrollments.
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