BEYOND THE NUMBERS
Repealing much of the Affordable Care Act (ACA) would cause 32 million people to lose coverage by 2026 and roughly double premiums in the individual insurance market, the Congressional Budget Office (CBO) estimated today.
CBO analyzed the impact of an ACA repeal bill that President Obama vetoed last year, which will likely be a model for the bill that congressional Republicans intend to pass this year. The vetoed bill would have immediately eliminated the ACA’s individual and employer mandates and repealed the ACA’s Medicaid expansion and marketplace subsidies after two years, while retaining the ACA’s market reforms and consumer protections (including the protections for people with pre-existing conditions).
Among the key findings:
- In the first full year after enactment, the number of uninsured would rise by 18 million, relative to current law. Premiums in the individual market would be roughly 20-25 percent higher than under current law. Roughly 10 percent of the population would live in an area where no insurers participated in the individual market. (Some insurers would withdraw from the market once the individual mandate was repealed, expecting enrollment to fall and the insurance risk pool to deteriorate as healthy people wait until they become sick to buy coverage.)
- In the third year after enactment, there would be 27 million more uninsured than under current law, and individual-market premiums would be about 50 percent higher. About half of the population would live in areas with no insurer participation in the individual market once the marketplace subsidies were also eliminated.
- By 2026, there would be 32 million more uninsured than under current law, and individual-market premiums would be about twice as high. Three-quarters of the population would live in areas without any insurer participation in the individual market.
The estimated increases in the number of uninsured are much greater than earlier CBO estimates because CBO and the Joint Committee on Taxation previously “had not estimated the changes in coverage from leaving the ACA’s insurance market reforms in place while repealing the mandate penalties and subsidies,” today’s report explains.