On May 24, 2017, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released estimates on the impact of the proposed H.R. 1628, the American Health Care Act of 2017 (AHCA), as passed by the U.S. House of Representatives on May 4, 2017. AHCA would partly repeal the Affordable Care Act (ACA).
The CBO estimates that AHCA would severely increase the number of persons without health coverage, as compared to the ACA:
- By 2018, 14 million more uninsured persons
- By 2020, 19 million more uninsured persons
- By 2026, 23 million more uninsured persons
A total of 51 million Americans would be uninsured by 2026, 23 million more than the 28 million who would be uninsured in 2026 under the ACA.
The CBO also estimates that AHCA would reduce the federal deficit. AHCA would eliminate various federal revenue streams established under the ACA, but would still cut the federal deficit by a net $119 billion (about $12 billion per year) through 2026.
The CBO estimates that net reductions in the federal deficit would occur mainly as a result of two factors that would have severe impacts on states and on disadvantaged persons:
- AHCA’s $834 billion in reductions in Medicaid federal financial participation (FFP) for state Medicaid agencies through 2026; and
- AHCA’s $665 billion cut in federal subsidies through 2026 for low-income persons lacking other sources of coverage.
The CBO estimates that AHCA would have a mixed impact on health insurance premiums:
- The CBO estimates that AHCA would drive premiums in the non-group health insurance market about 20 percent higher in 2018 than under the ACA and about 5 percent higher in 2019 than under the ACA (on average for all states).
- Such increases would occur mainly because fewer young and comparatively healthy persons would voluntarily sign up for coverage under AHCA, in the absence of the ACA’s income-related subsidies and tax penalties for failing to obtain health coverage.
- Starting in 2020, rates of increase in premiums would depend on the extent to which states obtain waivers available under AHCA.
- Average premiums in states that obtain such waivers could be about 20 percent lower by 2026 than under the ACA, in part because health insurance policies in such states could offer less comprehensive benefits.
- A new Patient and State Stability Fund created by AHCA would also help stabilize premiums for 2020-2026.
Additional information on the CBO estimates is available here on the CBO website.