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Monday, March 13, 2017

CBO Report: 52 Million Uninsured by 2026

The Congressional Budget Office today released its estimate of the effects of the assoholic Republican healthcare plan: 14 million Americans would lose their health insurance in the coming year, leading to 52 million being uninsured by 2026, the Washington Post reports.

Senate Minority Leader Chuck Schumer (D-N.Y.) responded to the report:

Ezra Klein in Vox, excerpt:
The Congressional Budget Office’s analysis of the GOP’s American Health Care Act is one of the most singularly devastating documents I’ve seen in American politics. For a thorough explanation of the findings, read Sarah Kliff’s explainer. But here is the one-sentence summary: Under the GOP’s bill, the more help you need, the less you get.

The AHCA would increase the uninsured population by about 24 million people — which is more people than live in New York state. But the raw numbers obscure the cruelty of the choices. The policy is particularly bad for the old, the sick, and the poor. It is particularly good for the rich, the young, and the healthy.

Here, in short, is what the AHCA does. The bill guts Medicaid, halves the value of Obamacare’s insurance subsidies, and allows insurers to charge older Americans 500 percent more than they charge young Americans.

Then it takes the subsidies that are left and reworks them to be worth less to the poor and the old, takes the insurers that are left and lets them change their plans to cover fewer medical expenses for the sick, and rewrites the tax code to offer hundreds of billions of dollars in tax cuts to the rich. As Dylan Matthews writes, it is an act of class warfare by the rich against the poor.

The result isn’t just 24 million fewer people with insurance: Of those who remain insured, the pool is tilted toward younger, healthier people who need help less, because many of the older, poorer people who need the most help can no longer afford insurance. As German Lopez notes, a 64-year-old making $26,500 would see his premiums rise by 750 percent. 750 percent! And with that 64-year-old gone, premiums are a little bit lower, because the pool is a little bit younger.

Let’s break that down. According to the CBO, the lower premiums Ryan celebrates (which are, mind you, only 10 percent lower after 10 years — and that’s after rising initially) are largely the product of driving older people out of the market and letting insurers offer plans that cover fewer medical expenses and require more out-of-pocket spending. This is not “lower premiums” as most Americans understand the term. . . .

But this is not fine. It is not decent, it is not compassionate, and it is not what Republicans promised. It is a betrayal of Donald Trump’s vow to protect Medicaid from cuts and to pass a health care bill that covers everyone with insurance that has lower deductibles and better coverage. It is a betrayal of Ryan’s promise to give Americans more choices — as it is only when you can afford insurance that you truly have the choice of which plan to buy. It is a betrayal of the older, rural voters who put Republicans in office and who will pay the most for heath insurance under this proposal.
The editorial board of USA Today writes:
The House GOP measure would greatly curtail the financial incentives for individuals to buy insurance on state exchanges while all but eliminating the penalties for not doing so. It would also scale back on Medicaid, the principal form of insurance for those on the bottom rungs of the income ladder.

The result would be bleak, if not horrific. One out of every 14 Americans who now has insurance would lose it over the next decade. The government's red ink would be reduced by $337 billion in the same period, but that would come largely by cutting assistance to poorer people while offering a whopping tax cut for families making more than $250,000 a year.

Given the CBO "scoring" of their bill, House Republicans ought to start over on their plan to repeal and replace Obamacare. Better yet, they should look for ways to retain and repair the current law. Instead, their initial reaction was to to blame the messenger by bad-mouthing the CBO.

Rep. David Brat, R-Va., for example, claimed that “the CBO has scored everything wrong, forever.” Health and Human Services Secretary Tom Price said "we disagree strenuously" and the CBO estimate is "just not believable."

Estimating the impact over time of any legislation is a Herculean task that does not always lend itself to perfect accuracy. But the CBO has long had a better track record than the Office of Management and Budget, which is under the control of the White House.

Republicans have traditionally been more supportive of the CBO, using it to counter more rosy estimates made by the Clinton and Obama administrations. What's more, when Republicans took control of both chamber of Congress in 2015, they dumped the longtime and well-respected director of the CBO, Douglas Elmendorf, and replaced him with Keith Hall, a proponent of "dynamic" scoring methods that generally see GOP proposals in a more favorable light.

Attacking the CBO now will only strengthen the argument that President Trump and his backers on Capitol Hill live in a world of alternative facts and relative truths. A superior approach would be to come up with a way to actually improve the nation’s health care system.

FYI, last week CNN reported the salaries of the top executives in the health insurance industry:
Aetna (AET) CEO Mark Bertolini received $17.3 million in 2015, the most recent year for which compensation has been reported. Cigna CEO David Cordani made the same amount. UnitedHealth (UNH) CEO Stephen Hemsley had total compensation of $14.5 million, while Anthem (ANTM) CEO Joseph Swedish received $13.6 million. Humana CEO Bruce Broussard received $10.3 million.
This is so wrong.

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