The current version of the American Health Care Act could cut the federal budget deficit by $337 billion over the next decade but increase the number of uninsured people by 86%, to 52 million, according to the Congressional Budget Office.
Most of the reductions in the federal budget deficit would occur after 2020.
About half of the increase in the number of uninsured people would be the result of reductions in federal support for Medicaid. The changes could cut the number of people who have Medicaid coverage in 2026 by 19%, to 57 million.
Use of individual coverage in 2026 might be 8% lower than under current law, and use of group health coverage might be 5% lower. Insurers could be covering 23 million people through commercial individual and family policies in 2026, and about 150 million through commercial group health policies.
Government revenue might fall $894 billion, but spending would fall $1.2 trillion.
An elimination of the Affordable Care Act net investment tax could be the biggest source of lost income. That change could cost the government $158 billion in revenue over 10 years.
Other big losses could come from the repeal of the ACA health insurer tax, which could cost $145 billion, and the repeal of an ACA Medicare tax imposed on high earners. The Medicaid change could cut revenue by $117 billion.
The CBO team came up with the numbers by comparing what it expects the world to look like from now through 2016 under the AHCA with what it expects the world to look like over that period under the current Affordable Care Act rules.
The projected 2026 group health enrollment change, for example, reflects the difference between what the CBO team thinks group health enrollment might look like in 2026 under the AHCA rules and what it might look like under the ACA rules, not the difference between actual group health enrollment today and the the CBO projection for 2026 under AHCA rules.
The current bill is based largely on the Better Way outline posted by House Speaker Paul Ryan last summer.
The House Ways & Means Committee and House Energy & Commerce Committee approved drafts of the proposal last week and forwarded the drafts to the House Budget Committee.
The Budget Committee is supposed to merge the drafts and forward the merged version to the House Rules Committee. The Rules Committee would develop rules for bringing the measure to the House floor.
If the House approves the measure, the measure would then go to the Senate, using the Senate budget reconciliation process. Under reconciliation, budget measures have needed just 51 votes to get through the Senate. Traditionally, ordinary bills have needed a filbuster-proof 60 votes.
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