CBO: Latest Senate Health Bill Would Increase Uninsured by 22M

Alicia Ault

July 20, 2017

Senate Republicans have revised their Better Care Reconciliation Act (BCRA) yet again, and, once more, the Congressional Budget Office (CBO) says the bill would lead to some 22 million additional people being without insurance by 2026.

The latest revamp of the BCRA was posted on the Senate Budget Committee's website today. The CBO followed quickly with an analysis that was not much different from its report on the first version of the bill, released in late June.

At that time, the CBO said the Senate bill would leave 22 million additional uninsured people by 2026. A flat repeal of the Affordable Care Act (ACA) — as proposed by Senate Republicans yesterday — would lead to 32 million more Americans without insurance, the CBO said.

The bipartisan agency says that under the new BCRA, 15 million more people would lose coverage in 2018 in comparison the number of people covered under the Affordable Care Act. Nineteen million people would be uninsured by 2020.

Unlike what would result from a proposed repeal of the ACA, the revised BCRA would not cause a death spiral of the individual insurance market, said the CBO. Instead, the nongroup insurance markets would "continue to be stable in most parts of the country." But premiums would increase — by 20% more than the current law projects in 2018 and 10% more in 2019 — but in 2020, they could expected to be 30% lower, relative to projections under the ACA, said the CBO.

But deductibles could be much higher. Under the ACA, the so-called "benchmark" plans on the exchanges are required to cover 70% of costs. But the latest Senate health plan requires plans to cover only 58% of costs.

Larry Levitt, a senior vice president with the nonprofit Kaiser Family Foundation, said that difference would lead to much higher deductibles. In a tweet, he said that the CBO's estimate of the deductible for someone making $26,500 in 2026 under the current law would be $800. But under the BCRA, that same individual, according to the CBO, would be looking at a $13,000 deductible in 2026, which is a 1525% increase, said Levitt.

That $13,000 would also exceed the $10,900 limit on out-of-pocket spending in 2026 and thus would not comply with the current law, said the CBO. Also, with such a large deductible, it's likely that "many people with low income would not purchase any plan even if it had very low premiums," said the agency.

The CBO said that the most recent BCRA proposal would produce greater cost savings than the initial version issued in June, in part because the latest proposal retains some of the ACA taxes.

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