The Congressional Budget Office (CBO) and Joint Committee on Taxation (JCT) released an updated projection on how repealing the ACA through budget reconciliation would lead to rising numbers of uninsured and increases in premiums on the marketplace.
CBO based projections on the Reconciliation Act passed in 2015 and vetoed by President Obama, which would have repealed key aspects of the Affordable Care Act (ACA) including the Medicaid expansion, subsidies for the marketplace, and the individual mandate (for more analysis of what the Reconciliation Act of 2015 proposed, see our past blogs on the subject).
CBO estimated that partial repeal of the ACA through reconciliation would cause 18 million more people to be uninsured almost immediately. Following the elimination of the Medicaid expansion and marketplace subsidies two years later, the number of uninsured people would rise by 27 million – doubling the number of uninsured under the ACA. In 10 years, the Reconciliation Act would lead the number of uninsured people to rise by 32 million – such that 59 million Americans under age 65, or 21 percent of the population, would be uninsured in 2026. Thanks to the Affordable Care Act and Medicaid, the rate of uninsurance among non-elderly adults has dropped from 18% in 2010 to 11% in 2015. Repealing the ACA would roll-back these historic coverage gains.
We know from other analyses of partial repeal of the ACA under the 2015 Reconciliation Bill that many of the people who would lose coverage are children and parents. According to an Urban analysis, the number of uninsured children and parents would more than double (4.4 million additional uninsured children and 7.6 million additional uninsured parents) under partial repeal of the ACA.
On top of increasing rates of uninsurance, CBO also estimated that premiums in the non-group marketplace would increase 20-25% in 2018 compared to current law, 50% by 2019, and 100% by 2026.
Additional research on the repeal of the ACA points to losses in other areas – job losses, billions of dollars for hospitals, providers, and states, treatment for opioid use disorders. The CBO estimates underscore the importance of the ACA to millions of people who have gained coverage through the marketplace, Medicaid, and the “welcome mat,” – as well as the importance of knowing what is in a replacement bill, should the ACA be repealed.