The new health care proposal's impact

     But on Monday, the Congressional Budget Office offered a nuts-and-bolts assessment that lays out in numbers the possible impact of the American Health Care Act, the brainchild of House Republicans, led by Speaker Paul Ryan, R-Wis. Here is the rundown:

The background: Obamacare --the Patient Protection and Affordable Care Act -- was approved in 2010 and went into effect in 2014. Anyone who was uninsured was required to buy a health care policy or pay a tax penalty. Insurance exchanges were set up in each state, along with subsidies for people who could not afford insurance. Additionally, anyone under age 26 could remain insured through a parent's plan. Pre-existing conditions were also covered.
    The plan also provides money to extend the solvency of the Medicare Trust Fund until 2029,  according to the government's website.

Number of Americans covered: More than 11.5 million individuals were signed up for coverage through Obamacare as of Dec. 24, 2016, according to the U.S. Centers for Medicare and Medicaid services. "Totals include 8.9 million returning consumers and 2.6 million new consumers." 

The proposed American Health Care Act: On his website, Ryan points out that his proposal would be in line with the Republicans long-standing promise to repeal and replace Obamacare. However, it keeps two key provisions of Obamacare: allowing young people to stay on their parents’ insurance plan until they are 26 and ensuring no one with a pre-existing condition is denied health care.
     Here are four of the other major provisions of the American Health Care Act, as summed up by the Congressional Budget Office:

• The new law would eliminate penalties imposed to get people to buy health insurance, along with penalties in conjunction with a requirement that large employers offer employees coverage that meets specific standards.
• It would relax current requirements preventing insurers from charging older people premiums more than three times larger than the premiums charged to younger people in the non-group and small-group markets. Unless there is a different limit set by a state, “the legislation would allow insurers to charge older people five times more than younger ones, beginning in 2018,” according to the CBO.
• It caps the growth in per-enrollee payments for most Medicaid beneficiaries to no more than the medical care component of the consumer price index, a measure of inflation, starting in 2020.
• It removes the requirement, beginning in 2020, that insurers offering plans in the non-group and small-group markets “generally must offer plans that cover at least 60 percent of the cost of covered benefits.”

 Number of Americans covered: The Congressional Budget Office predicts a significant drop in the number of Americans covered by insurance. In 2018, "14 million more people would be uninsured under the legislation than under current law."
     Later, the report states, "following additional changes to subsidies for insurance purchased in the non-group market and to the Medicaid program, the increase in the number of uninsured people relative to the number under current law would rise to 21 million in 2020 and then to 24 million in 2026. The reductions in insurance coverage between 2018 and 2026 would stem in large part from changes in Medicaid enrollment—because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped. In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law.” 

Savings: While it would leave millions without insurance, the program would reduce federal deficits by $337 billion over the 2017-2026 period. "The largest savings would come from reductions in outlays for Medicaid and from the elimination of the Affordable Care Act’s subsidies for non-group health insurance," the report says. "The largest costs would come from repealing many of the changes the ACA made to the Internal Revenue Code—including an increase in the hospital insurance payroll tax rate for high-income taxpayers, a surtax on those taxpayers’ net investment income, and annual fees imposed on health insurers—and from the establishment of a new tax credit for health insurance."
 

    To know more:

• Centers for Medicaid and Medicare Services: Health Insurance Marketplaces 2017.

• Congressional Budget Office: American Health Care Act, March 13, 2017.

• Healthcare.gov: How to get or stay on a parent's plan.

• Healthcare.gov: Read the Affordable Care Act.

• Internal Revenue Service: Affordable Care Act Tax Provisions. 

• Medicare.gov: The Affordable Care Act & Medicare.

    Related:  

    How affordable is Obamacare?

    10 presidents and the fight over health care

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