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House Bill to Defund Insurance Exchanges Would Lead to Half a Million More Uninsured in 2015

The House is expected to vote this week on yet another bill to undermine health reform implementation.  H.R. 1213 would repeal the law’s grants for states to fully fund their work setting up health insurance marketplaces or “exchanges,” which are scheduled to be up and running by January 1, 2014.  As a result, fewer people would get help buying insurance through the exchanges and 500,000 more people would be uninsured in 2015, according to a new Congressional Budget Office analysis.

A key element of health reform, the exchanges will give individuals and small businesses a choice of private health insurance plans.  To help make this coverage affordable, health reform provides help with premiums and cost-sharing charges for low- and moderate-income people buying coverage through the exchanges.

If Congress repeals the grant funding, fewer states’ exchanges will be ready on time and some exchanges will be only partly operational, CBO says.  For example, some exchanges will initially be limited in accepting enrollees.  As a result, 2 million fewer people will participate in the exchanges in 2015, CBO estimates.

Notably, CBO finds that the vast majority of the bill’s $14 billion in savings results from reduced spending on premium and cost-sharing help for low-income people to buy insurance, not the direct elimination of the roughly $1.9 billion in grants to help set up the exchanges.