Both the Congressional Budget Office and President-elect Donald Trump may be putting pressure on congressional Republicans to work with Democrats to come up with an Affordable Care Act replacement bill, not just de-fund ACA spending programs.
Related: House approves ACA attack framework
Trump, who is set to take the oath of office Friday, said in a weekend interview with the Washington Post, which is posted behind a login wall, that he wants Congress to replace the ACA with a program that provides “insurance for everybody.”
He also said he would use the power of the presidency and Twitter if Congress gets cold feet and is slow to pass an ACA replacement plan.
The Congressional Budget Office, meanwhile, posted a grim analysis of the effects of an ACA de-funding proposal.
Because of the way the Senate rules work, Republicans can probably get a measure that would kill major ACA spending programs, such as the ACA premium tax credit program and the cost-sharing reduction program, through Congress without help from Democrats. But they probably need at least eight votes from Democrats and independents in the Senate to pass a bill that would repeal all of the ACA, or replace the ACA.
Some Republicans have proposed de-funding the ACA quickly, and then trying to change or replace the law later.
If an ACA de-funding proposal became law, and no other ACA changes occurred, de-funding of the ACA premium tax credit subsidy and cost-sharing reduction subsidy would probably increase the number of people who were uninsured by 18 million in the first new plan year following the effective date of the de-funding effort, and it would probably increase premiums for individual major medical coverage by 20 percent to 25 percent, the CBO analysts predict.
The cost of individual health coverage would increase sharply whether consumers bought the coverage through an ACA public exchange or outside the exchange system, the analysts predict.
By 2026, if the ACA de-funding measure and other laws stayed in place, unchanged, the total number of uninsured people would be 32 million higher than if the ACA stayed in place, and individual major medical premiums would be about twice as high, the analysts predict.
Market withdrawals would eliminate access to individual health coverage for about half of Americans in the first year after the end of ACA subsidies took effect, and for about three-quarters of Americans by 2026, the analysts predict.