Tuesday, January 17, 2017

Congressional Budget Office reports negative results of Affordable Care Act repeal. Trump promises to fire CBO staff.

The first sentence is correct. The second is not - but it would not be surprising. Neither would it be surprising to find out that Congressional Republicans would support Trump’s action against their own CBO. But I digress.

Here’s the update on the GOP’s unhealthy approach to health - and what it will cost the country if implemented. The New York Times reports Health Law’s Repeal Could Raise Costs and Number of Uninsured, New Report Says.

The nonpartisan Congressional Budget Office said on Tuesday that repealing major provisions of the Affordable Care Act, while leaving other parts in place, would cost 18 million people their insurance in the first year and could increase the number of uninsured Americans by 32 million in 10 years, while causing individual insurance premiums to double over that time.

The budget office analyzed the probable effects of a Republican repeal bill like the one approved in Congress but vetoed early last year by President Obama.

The C.B.O. report, released after a weekend of protests against repeal, will only add to the headaches that President-elect Donald J. Trump and congressional Republicans face in their rush to gut President Obama’s signature domestic achievement and try to replace it with a health insurance law more to their liking.

The bill that the budget office analyzed would have eliminated tax penalties for people who go without insurance. It would also have eliminated spending for the expansion of Medicaid and subsidies that help lower-income people buy private insurance. But the bill preserved requirements for insurers to provide coverage, at standard rates, to any applicant, regardless of pre-existing medical conditions.

“Eliminating the mandate penalties and the subsidies while retaining the market reforms would destabilize the nongroup market, and the effect would worsen over time,” the budget office said.

That squares with the predictions of a former health insurance CEO reported here yesterday.

The report is likely to slow efforts to dismantle the health care law. Mr. Trump and Republican lawmakers say they intend to replace the law, but they have not agreed on a replacement plan.

Paraphrased from Beyond Thunderdome :
CBO: So, what’s the plan?
GOP: [laughing] PLAN? There ain’t no plan!
See the video clip on YouTube.

UPDATE: Paul Waldman (Washington Post/Plum Line) thinks that Donald Trump may have just destroyed the Republican effort to repeal Obamacare. He promised universal coverage and lower deductibles. Q: Now how are the poor GOPlins going to do that? A: They aren’t.

We should begin with the assumption that nothing Trump says can be taken at face value; the “plan” that he claims is being devised could be no more real than the secret plan to defeat the Islamic State he used to claim that he had formulated. But that’s not the point. What matters is this: Donald Trump just emphatically promised universal health coverage. That’s an absolutely gigantic promise, and it’s one that Republicans have no intention of keeping.

But now they’re stuck with it. Democrats will be saying, “President Trump promised that everyone would be covered!” every day for as long as this debate goes on. Every time a congressional Republican is interviewed on this topic, they’ll be asked, “President Trump said that everyone would be covered. Does your plan do that?,” and they’ll have to bob and weave as they try to avoid admitting the truth.

That’s because the Republican plan, in whatever final form it takes, will absolutely, positively not cover everyone. Universal coverage isn’t even one of their goals. Republicans believe it’s much more important to get government as far away from health care as possible. In place of the ACA’s expansion of Medicaid and subsidies for the purchase of insurance that have extended coverage to 20 million more people than used to have it, they’ll be offering some tax credits and health savings accounts, which would be very good for the healthy and wealthy, but not so great for other people.

If Trump understood the political and policy challenges Republicans face, he’d know that high deductibles are supposed to be complained about and wielded as evidence that the ACA is a failure, but you’re not supposed to actually promise that any Republican plan will lower them. You want people to assume that, of course, but you don’t want to promise it directly, because then you might be held accountable for that promise.

But Trump says whatever comes into his head, and whatever seems like it might be popular. People hate out-of-pocket costs, so he promises low deductibles. People don’t like the idea of tens of millions losing their coverage, so he promises that everyone will be covered.

And now, congressional Republicans are going to have to answer for breaking a promise they didn’t even make. At a moment when opposition to the repeal of the ACA is gathering strength, this was the last thing they needed.

But, Hallelujah, they’ve got it.

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