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POLICY INSIGHT
BEYOND THE NUMBERS

Previewing a House GOP Leaders’ Health Plan, #2: Repealing the Affordable Care Act

The health plan that House Republican leaders are developing would almost certainly repeal the Affordable Care Act’s (ACA) coverage provisions, just as House Budget Committee Chairman Tom Price’s budget proposed.  By eliminating the Medicaid expansion and health insurance marketplaces — and the subsidies to help those of modest means buy marketplace coverage — millions of Americans who gained coverage would lose it, ending up uninsured.  Millions more who would otherwise gain coverage in the future would remain uninsured.  Particularly hard hit would be those who have most benefited from the ACA: the near-elderly, African Americans, and low-income families. 

  • Twenty million people who are newly insured would lose their coverage.  As of early 2016, 20 million adults have gained health insurance coverage through health reform, according to Department of Health and Human Services (HHS) estimates — 17.7 million adults who gained coverage through the marketplaces or Medicaid expansion, and 2.3 million young adults who gained coverage as early as 2010 under a provision that let them stay on their parents’ private insurance plans through age 26.

    That’s consistent with other government and private survey data showing substantial coverage gains, including the Census Bureau’s Current Population Survey (CPS) and American Community Survey, the Centers for Disease Control and Prevention’s National Health Interview Survey, the Gallup-Healthways’ Well-Being Index, the Urban Institute’s Health Reform Monitoring Survey, the Commonwealth Fund’s Affordable Care Act Tracking Survey, and RAND’s Health Reform Opinion Study.

    The CPS data show particularly notable coverage gains between 2013 and 2014 among near-elderly adults (a 25 percent cut in their uninsured rate), African Americans (26 percent), and those between 100 percent and 300 percent of the federal poverty line (26 percent).  Moreover, states that took full advantage of health reform’s coverage expansions by adopting the Medicaid expansion for low-income adults experienced much larger coverage gains, as the Urban Institute data indicate.  The uninsured rate among non-elderly adults in the 29 states that expanded Medicaid coverage by September 2015 dropped more than half since the third quarter of 2013, compared to slightly more than one-quarter in states that didn’t expand Medicaid (see chart).

  • Millions of uninsured who are slated to gain insurance in the future would remain without it.  The Congressional Budget Office (CBO) now projects that by 2026, 24 million more Americans will have health coverage than would have without health reform.  All told, CBO expects that 93 percent of citizens would be insured by 2026, a historic high.

Repealing health reform’s coverage provisions would undo these historic coverage gains and block expected future coverage increases, leaving tens of millions more uninsured and underinsured than under current law.

Read the rest of our series previewing a House GOP leadership health plan here.