The Congressional Budget Office (CBO) May 24 released an estimate of the House-passed American Health Care Act’s (AHCA, H.R. 1628) effects on the federal budget and health insurance coverage. The CBO scored previous versions of the bill [see Washington Highlights, March 17], but the updated score incorporates several new amendments that added funding to the Patient and State Stability Fund Grants and allowed for states to waive the Affordable Care Act’s (ACA, P.L. 111-148 and P.L. 111-152) requirement establishing essential health benefits.
According to the CBO, an additional 23 million people are expected to be uninsured by 2026 under the AHCA as compared to current law. The AHCA would also reduce federal Medicaid spending by $834 billion over ten years, while 14 million fewer people are expected to be enrolled in the program by 2026 than under current projections. The analysis indicates that the bill would increase the number of uninsured broadly, but “the increase would be disproportionately larger among older people with lower income – particularly people between 50 and 64 years old with income of less than 200 percent of the federal poverty level.”
AAMC President and CEO Darrell G. Kirch, MD, May 24 noted these cuts “will cripple the health care safety net designed to help the most vulnerable patients – many of whom depend on the nation’s teaching hospitals and physicians for their care.
The CBO report also estimates that beginning in 2020, about one-sixth of the population will live in areas in which the nongroup insurance market will start to become unstable, largely as a result of premium increases in states that waive the essential health benefits requirements and community rating.
Dr. Kirch called on the Senate “to take an approach to health care reform that commits to high-quality, affordable, comprehensive coverage for at least as many people as are currently insured, including maintenance of the Medicaid expansion and protections for individuals with preexisting conditions.”
Meanwhile, the AAMC submitted a May 23 letter to Senate Finance Committee Chair Orrin Hatch (R-Utah) detailing a set of policy priorities that should be included in any reform legislation.