The Congressional Budget Office (CBO) March 13 released an estimate of the American Health Care Act’s effects on the federal budget and health insurance coverage. According to the CBO report, the bill would reduce federal funding by $1.2 trillion in total from 2017-2026, largely by cutting Medicaid spending ($880 billion in Medicaid cuts over that period, which represents a 25 percent reduction in federal Medicaid spending by 2026). These savings would be offset by reduced revenues of $883 billion due to the repeal of various taxes included in the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). On a net basis, the AHCA would result in a federal deficit reduction of $337 billion from 2017-2026.
The CBO score estimates that relative to current law, 14 million more people will be uninsured in 2018, with that number increasing to 24 million additional uninsured by 2026. Furthermore, the changes to the Medicaid program will result in 14 million fewer people with Medicaid coverage by 2024.
In response to the CBO report, AAMC President and CEO Darrell G. Kirch, MD, stated, “These are people, not numbers – people who all too often will be left without access to regular care, putting their health at risk. Many of them will come to our nation’s teaching hospitals, but they may wait until they are in crisis and the costs and complexity of treatment have increased.”
The House Budget Committee March 16 approved a motion by a vote of 19-17 to send the legislation to the full House for consideration. Reps. Mark Sanford (R-S.C.), Dave Brat (R-Va.), and Gary Palmer (R-Ala.), all members of the House Freedom Caucus, opposed the measure. The panel also approved four other advisory amendments that do not have to be incorporated into the legislation. These include allowing states to accept Medicaid block grants, immediately freezing Medicaid expansion enrollment, shifting the bill’s tax credits to provide more funding to lower-income individuals, and placing work requirements on able-bodied adults without children in Medicaid.
The House Rules Committee is expected to consider the legislation next week before it moves to the full House for a final vote.