CBO: The AHCA Will Leave 23 Million More People Uninsured by 2026

The Congressional Budget Office released a new score on the GOP health care bill—and its predictions are devastating.
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Update, May 24, 7:00 p.m.: The nonpartisan Congressional Budget Office released a new score of the American Health Care Act today. Their findings: In 2018, 14 million more people would be uninsured under the AHCA than under current legislation. By 2026, that number would increase to 23 million.

The AHCA would allow states to waive rules that prevent insurers from over-charging people with pre-existing conditions and that dictate the essential health benefits every insurance plan should include—and the CBO says that would have a major, potentially devastating impact on people's access to health care. For people living in states that waive these rules, "it would become more difficult for less healthy people (including people with pre-existing medical conditions)...to purchase insurance because their premiums would continue to increase rapidly," the budget office states, noting that these premiums would vary based on a person's health status and the benefits provided to them.

U.S. Senate Majority Leader Mitch McConnell told Reuters today that the Senate is already planning on making substantial changes to the AHCA bill passed by the House GOP—which was the bill reviewed by the CBO—but McConnell seemed unsure if Republicans will get the 50 votes needed to pass the new health care bill. "I don't know how we get to 50 (votes) at the moment. But that's the goal," he told the news outlet. "And exactly what the composition of that (bill) is I'm not going to speculate about because it serves no purpose."

Update, May 4, 3:00 p.m.: The House GOP narrowly passed the health care bill with 217 votes. It is now headed to the Senate.

Update, May 4, 11:00 a.m.: Republicans really want to pass their Obamacare replacement, the American Health Care Act (AHCA), today. In a last-minute effort to get enough votes, they made some additional changes to the AHCA. As we reported earlier, the AHCA would now allow states to waive rules that prevent insurers from over-charging people with pre-existing conditions and that dictate the essential health benefits every insurance plan should include.

By insurer standards, pre-existing conditions include things like: pregnancy, postpartum depression, having a C-section, surviving a sexual assault, or surviving domestic violence. Since this impacts a wide range of Americans, Republicans have now added a clause that provides $8 billion in funding (over the next five years) to people with pre-existing conditions. This money is supposed to mitigate some of the consequences of the state-by-state waivers—and it's reportedly supposed to calm the fears of some of the Republicans who expressed concerns about those waivers.

But $8 billion spread out over a 5-year period is simply not enough to serve all the Americans who could lose insurance because they have pre-existing conditions. This provision might quell the anxieties of some legislators, but it certainly won't do much to help the people those lawmakers are supposed to be serving.

Another new clause allows states to decide if insurers should be able to charge older adults more for insurance than they charge younger ones. This could easily price older Americans out of their health care plans—and that's messed up.

These changes could have a harmful effect on many Americans. Does someone really deserve to be charged more for insurance because they've been assaulted or abused? Because they've made the very normal decision to start a family? Because they've aged? That's just plain cruel. And if you agree, it's not too late to do something about it.

Call. Your. Congressperson. The vote happens later today, and we still have time to stop it. Phone calls can make a real difference—and they're the fastest, most immediate way to get in touch with your local representative. And remember, even if this passes the House of Representatives today, it still needs to pass the Senate—which gives you another opportunity to get involved. If this health care plan makes you mad, do something about it! Your voice matters—make yourself heard.


Original report:

Do you...

  • Think people with pre-existing conditions should have access to affordable health care?
  • Believe insurance providers should cover basic benefits like maternity/newborn care, mental health care, and prescription medications?
  • Feel congresspeople should give you access to the same high-quality health care plans they give themselves?

If you answered yes to any of those questions, you should pay attention to the GOP's newly proposed health care amendment. Because it threatens to take all of that away.

The GOP amendment is giving new life to the American Health Care Act—an Obamacare replacement plan that Republicans withdrew in March because it failed to get enough support from Congress.

The Trump administration has long vowed to overturn Obamacare—also known as the Affordable Care Act (ACA). But the plan they came up with, the American Health Care Act (AHCA), fell short. Standard & Poors estimated that 4 to 6 million Americans would lose health insurance by 2020 under the AHCA. And the Congressional Budget Office (CBO) predicted that the plan would cause 24 million people to lose health insurance over the next decade.

In March, Congress was set to vote on the AHCA. But the House GOP pulled the bill before the vote—it hadn't received enough support to pass.

Now, the AHCA is back—thanks to an amendment drafted by New Jersey Representative Tom MacArthur. MacArthur's amendment panders to the Freedom Caucus, a group of conservative and libertarian House members. Securing votes from these representatives could be what the AHCA needs to move forward. (At the least, it will make a difference in how much support the plan has—even if it's just a small difference.)

This new amendment lets states decide what insurers should do about pre-existing conditions.

Obamacare had its issues, but it helped people with pre-existing conditions afford quality health care. Before Obamacare, insurers could deny people health care coverage for all kinds of reasons—like pregnancy, autism, and a history of in-patient mental health care. But under Obamacare, insurance providers were no longer allowed to discriminate. It became illegal to deny health care coverage to someone with a pre-existing condition—or to charge them higher premiums.

The new AHCA amendment allows states to waive this key provisions. A state wants to allow insurers to charge people with pre-existing conditions more money for insurance? They can request a waiver to do so. It's that easy.

It also lets states stop covering essential benefits.

Obamacare required that insurers cover 10 essential benefits: outpatient care, emergency care, hospitalization, maternity and newborn care, mental health and substance abuse care, prescription medications, rehabilitative and habilitative care, lab services, pediatric care (including routine oral and vision services), and preventive services (including chronic disease management).

The waivers apply here, too. So if a state wants to stop covering all 10 essential benefits, it can request to waive the requirement.

One last thing: 70 percent of Americans think insurers should cover people with pre-existing conditions, and 61 percent think the government should provide an essential benefits package (that includes maternity care and mental health care), according to a recent Washington Post-ABC News poll. A majority of voters want to keep these provisions, so why is the government making it easier for states to throw them out?

And GOP representatives have made congressional staff exempt from the bill—meaning you could lose your benefits while they keep theirs.

MacArthur added a provision that protects Congress members and their staff from these changes. That means congressional staff can't lose their access to essential health benefits or pre-existing condition coverage—even if you, their constituents, do. That speaks for itself. (A MacArthur spokesperson reportedly confirmed to Vox reporter Sarah Kliff that this provision exists within the bill.)


It also begs the question: If Congress wants access to these Obamacare benefits, why are they willing to let your state take them away from you?

Remember: This amendment hasn't been passed yet.

Obamacare is still in tact. Neither the AHCA—nor this amendment—have been passed yet. And there's been no word on when the vote will happen.


