The Congressional Budget Office's score of Trumpcare is complete, and while the Freedom Caucus isn't going to hate it as much as everyone else because it saves a bit of money—$337 billion over 10 years—it's a big, big blow to everyone who has said people will keep their insurance. Like popular vote loser Donald Trump. Because on the number of insured front, it's very bad. It's worse than before the Affordable Care Act, when we were in a massive healthcare crisis. In fact, the CBO estimates there will be six million more uninsured people in 2026 than there were in 2009.
CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.
Later, following additional changes to subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.
Most estimates from think tanks put the increase in the number of uninsured at 10 to 15 million in ten years’ time. The CBO says that happens next year—meaning 2018. That's 14 million who would not be uninsured if Obamacare stands, but will lose insurance under Trumpcare, if it passes. That's devastating.
In 10 years’ time the total uninsured population—those who would still be uninsured under Obamacare plus the ones Trumpcare forces out—would be 52 million. Remember back before the Affordable Care Act? Remember that there were 46 million uninsured people in the U.S.?Trumpcare makes it worse!
And as most analysts have concluded, the costs would be considerably higher for older Americans.
The changes in premiums would vary for people of different ages. The change in age-rating rules, effective in 2019, would directly change the premiums faced by different age groups, substantially reducing premiums for young adults and raising premiums for older people. By 2026, CBO and JCT project, premiums in the nongroup market would be 20 percent to 25 percent lower for a 21-year-old and 8 percent to 10 percent lower for a 40-year-old—but 20 percent to 25 percent higher for a 64-year-old.
In other words: Republican voters. Watching Republicans spin this—the fact that they'll make the crisis of the uninsured worse that it was pre-Obamacare—is going to be fascinating.
Republicans only narrowly control the Senate, and with constituent pressure we can blow TrumpCare a humiliating defeat. Call the Capitol Hill switchboard at (202) 224-3121, ask for your Senators’ office and urge them to reject TrumpCare.