Trump’s ACA repeal proposal would cut coverage for 20M

Donald Trump speaks at a lectern

A new analysis shows that repealing and replacing the Affordable Care Act, as presidential candidate Donald Trump has proposed, would strip health insurance from millions of Americans while increasing the federal deficit.

Trump’s approach to repeal the ACA would also increase average premiums for individuals who procure health plans on their own, and increase the federal deficit due to loss in savings from the ACA’s Medicare reforms, says a study from The Commonwealth Fund conducted jointly with RAND Health.

If insurance subsidies, Medicaid expansion and the ban against pre-existing condition exclusions were fully repealed, here’s a look at what researchers say would happen:


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  • In 2018, 231.9 million people would be insured under Trump's plan. Maintaining the ACA would result in 251.6 million people insured, a difference of close to 20 million.
  • Out-of-pocket costs in the individual, nongroup market would be $4,700 per person on average, $1,500 more than if the ACA is maintained.
  • The federal deficit would increase $33.1 billion. Gradual modifications to the ACA are projected to net $0 in deficit changes, according to the analysis.

On the flip side, here’s a snapshot of what the researchers found in modeling Hillary Clinton’s plan to improve President Barack Obama’s signature healthcare reform law:

  • Increasing tax credits for people with private insurance would decrease the uninsured population by 9.6 million.
  • Bolstering ACA tax credits for eligible enrollees would result in 1.7 million people gaining coverage.
  • Patching up the “family coverage glitchwould increase the insured population by 2.8 million people.
  • Adding a public option plan to every state marketplace would boost the covered population by 400,000 people.

Trump’s healthcare talking points--block grants for Medicaid financing and allowing insurance plans to be sold across state lines--would have the effect of reducing coverage for 25 million people and 17 million people, respectively, the report adds.

Meanwhile, a preliminary estimate from the Committee for a Responsible Federal Budget says that over a span of 10 years, Clinton's health policies would add $200 billion to the national debt, while Trump's health proposals would tack on $5.3 trillion.

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