CBO scores new repeal-and-delay bill, says it would increase uninsured by 32M

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The CBO projects that if the GOP's new repeal-and-delay bill is enacted, it will increase the number of uninsured by 17 million in 2018.

Republicans’ latest iteration of a healthcare bill—now dubbed the Obamacare Repeal Reconciliation Act of 2017—would increase the number of uninsured individuals by 32 million and double individual market premiums by 2026, according to the Congressional Budget Office.

The just-released bill (PDF) is an updated version of the 2015 “repeal-and-delay” bill that congressional Republicans passed—and President Barack Obama vetoed. It emerged under a new name on Wednesday, followed in short order by a CBO score that closely mirrors the agency’s projections about the original bill.

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Like its predecessor, the new GOP bill would be a partial repeal of the Affordable Care Act, rolling back some of its core provisions—including Medicaid expansion, subsidies for individual marketplace plans and several of the law’s taxes—effective in 2020. That delay is meant to give Republicans time to come up with an ACA replacement.

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The bill would immediately repeal the individual mandate upon its enactment, however. Thus, the CBO projects that if the measure is enacted, it will increase the number of uninsured by 17 million in 2018. Most of that would be due to the loss of the individual mandate, but another factor, the agency says, could be the exit of some insurers from the marketplace in 2018.

“They would be leaving in anticipation of further reductions in enrollment and higher average healthcare costs among enrollees who remained after the subsidies for insurance purchased through the marketplaces were eliminated,” the report says.  

The CBO adds that such insurer exits would likely continue in later years, projecting that by 2020 about half of the population would live in areas with no individual market insurer. That would increase to 75% of the population by 2026, the report adds.

As for the budgetary effects of the bill, the CBO estimates that it will reduce the federal deficit by $473 billion from 2017 to 2026. That calculation includes a $1,429 billion reduction in outlays, partially offset by a $956 billion decrease in revenues.