Senate Bill Could Add 22 Million to 2026 Uninsured Total: CBO

The Senate’s new Better Care Reconciliation Act bill might have roughly the same effect on the number of people with health coverage as the health bill the House passed in May.

(Related: New Senate Health Bill Includes Waiver Wild Card)

Analysts at the Congressional Budget Office have published figures supporting that prediction in a new analysis of the BCRA bill.

A copy of the analysis is available here.

The analysts predict that, under the BCRA bill rules:

• Individual and family enrollment could fall to 18 million by 2026, down from 19 million today. (The CBO predicted individual and family enrollment would be 19 million in 2026 under the House American Health Care Act bill rules.)

• Group health enrollment could fall to 152 million, down from 155 million today. (The CBO predicted group health enrollment would be 149 million in 2026 under AHCA rules.)

• The number of people with Medicaid or Children’s Health Insurance Program coverage could fall to 56 million in 2026, down from 67 million today. (The CBO predicted 57 million people would have Medicaid and CHIP coverage in 2026 under AHCA rules.)

• The number of uninsured people could increase to 49 million in 2026, from 26 million today, and from 27 million if the current rules stay in effect and work as the CBO expects. (The CBO predicted the country would have 51 million uninsured people in 2026 under AHCA rules.)

• The federal budget deficit would be about $321 billion smaller than it would be without BCRA-related changes in spending programs, tax programs and other programs. (The CBO predicted the AHCA bill that passed in the House would narrow the federal budget deficit by $119 billion.)

The CBO analysts predict that, especially in states that used a BCRA provision that would let them soften the current Affordable Care Act health insurance rules, the individual health insurance market would be stable.

Out-of-pocket costs and premiums might be very high, but most people would at least have the ability to buy individual coverage, the analysts predict.

In May, CBO analysts predicted the House health bill would leave consumers with health problems without access to individual commercial major medical coverage at any price in much of the country.

BCRA v. AHCA 

The BCRA bill is the Senate’s version of H.R. 1628, a bill that would replace the Affordable Care Act premium tax credit subsidy systems and repeal Affordable Care Act penalties, taxes and coverage purchase mandates. Members of the House passed another version of H.R. 1628, the American Health Care Act bill, by a 217-213 vote May 4.

Sen. John Cornyn, R-Texas, the Senate majority whip, has said Senate Majority Leader Mitch McConnell and other Senate leaders hope to have the Senate vote on the BCRA bill before members of the Senate leave for the Independence Day holiday.

Republicans hold just 52 seats in the Senate. McConnell has been struggling to get more conservative and more moderate Republicans to unite behind the same Affordable Care Act change bill.

The CBO Report

Here’s a look at what CBO analysts have been saying about actual health coverage enrollment, and about how enrollment might change under the House AHCA bill or the Senate BCRA bill.

Individual Major Medical

2013 (Mark Farrah Associates): 12.5 million

2017 (January 2017 CBO Report): 19 million

Affordable Care Act 2019 (Today’s CBO Report): 27 million

Affordable Care Act 2026 (Today’s CBO Report): 25 million

House AHCA 2019 (May 24 CBO Report): 19 million

House AHCA 2026: (May 24 CBO Report): 19 million

Senate BCRA 2019 (Today’s CBO Report): 19 million

Senate BCRA 2026: (Today’s CBO Report): 18 million

(Image: Thinkstock)

Employment-Based Coverage

2013 (February 2013 CBO Report): 154 million

2017 (March 2016 CBO Report): 155 million

Affordable Care Act 2019 (Today’s CBO Report): 152 million

Affordable Care Act 2026 (Today’s CBO Report): 152 million

House AHCA 2019 (May 24 CBO Report): 150 million

House AHCA 2026: (May 24 CBO Report): 149 million

Senate BCRA 2019 (Today’s CBO Report): 150 million

Senate BCRA 2026: (Today’s CBO Report): 152 million

Medicaid and Children’s Health Insurance Program:

2013 (March 2016 CBO Report): 36 million

2017 (March 2016 CBO Report): 67 million