The Congressional Budget Office Has Scored Trumpcare 2.0, And It Wasn't Kind

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The GOP plan to repeal and replace the Affordable Care Act would cut Colorado's Medicaid funding by $14 billion, and cause 23 million people nationally to lose health coverage, according to the latest estimates by the Congressional Budget Office. Durbin called for improvements to the Affordable Care Act, not repeal. Bill Cassidy of Louisiana, said they don't want to see that happen.

But the AHCA will kick millions of people off of their insurance plans, and by 2026, an estimated 51 million Americans won't have health insurance.

Earlier this month the House of Representatives passed the American Health Care Act after updating it from a similar version which did not come to a vote in March. House Republicans have said as much.

"Three weeks ago-before the CBO had the chance to determine the impact of Trumpcare-the GOP voted to gut Medicaid and strip guarantees for basic services and preexisting conditions", Rep. Keating said.

Many congressional Republicans took a sharply different tack, emphasizing some of the report's more positive findings. Republicans have a 52 majority in the Senate, meaning that they can only afford to lose two votes if Vice President Mike Pence were to break the tie. It's always been known that repealing Obamacare, which the Trump plan does, would result in millions of people losing their health insurance. That dollar figure was a considerable change from the original version of the bill that CBO said would have saved $337 billion, but lawmakers made a decision to spend back some of those savings on help for those likely to be cut off from insurance.

Trump and Republicans celebrated the House's narrow May 4 passage of the bill in a Rose Garden ceremony after several embarrassing setbacks, even as GOP senators signaled it had little chance of becoming law without significant changes.

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States could also get waivers that would allow insurers to charge more for people with pre-existing conditions, a practice banned under the ACA. Some states, as noted above, would seek waivers that could destabilize their markets.

Ryan defended the idea, citing the fact that the new law would require states seeking a waiver to have a so-called high-risk pool in place, where sicker people would turn to purchase insurance.

The budget office projected that premiums in those states would be lower for healthy people than under current law because their coverage would be narrower, but did not estimate an amount.

"A state has to have a risk system in place" to get a waiver, "and that risk system is specifically created to make sure that people with a catastrophic illness, who has a preexisting condition, also gets access to affordable healthcare", Ryan said.

For states that waived essential health benefits, the CBO found that out-of-pocket spending on the types of care that would no longer be required - such as maternity care, mental health services, and treatment for substance abuse - "could increase by thousands of dollars in a given year". There is no reason to believe, as the CBO does, that there will be around 18 million people enrolled in the exchanges by this time next year. Health care premiums would likely vary significantly based on health status and the types of benefits provided, and less-healthy people would face extremely high premiums, according to the CBO.

The report said that under Obama's law, the nation's health insurance market is expected to remain "stable in most areas" because federal subsidies to millions of consumers largely rise with premiums.