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House Speaker Paul Ryan holds a copy of the American Health Care Act, the House Republican leadership's plan to repeal and replace the Affordable Care Act, which is already facing opposition from conservatives in the House and Senate. Chip Somodevilla/Getty Images hide caption

House Speaker Paul Ryan holds a copy of the American Health Care Act, the House Republican leadership's plan to repeal and replace the Affordable Care Act, which is already facing opposition from conservatives in the House and Senate.

The Republican health care bill would not affect Americans equally. Older, poorer people would see big reductions in coverage and cost increases, according to a report from the nonpartisan Congressional Budget Office. This first step in the GOP plan to repeal and replace the Affordable Care Act, also known as Obamacare, would also create a modest deficit reduction.

The report hands Democrats more ammunition in attacking the bill, while Republicans are divided: Some are playing defense, while others are backing away, and some are also proposing changes.

To see the potential impact of the bill as it stands, here are five charts, based on the CBO analysis.

Uninsured spike immediately, then rise more slowly

First things first: The Republican health care bill would greatly ramp up the number of people who are uninsured. Currently, around 9.5 percent of Americans younger than 65 are uninsured. Under the Republican bill, the uninsured rate in 2026 would be nearly double that, at 18.6 percent, compared with 10 percent under the Affordable Care Act.

Put into raw numbers, here's how the growth in the number of uninsured looks: In 2018, the number of uninsured would be 14 million larger under the Republican bill than under Obamacare. In 2026, it would be 24 million larger.

That big upswing in 2018 would be largely attributed to repealing the penalties that came as part of the individual mandate not having a fine would lead lots of people to decide not to get insured. In addition, rising premiums would deter some from buying insurance.

In subsequent years, Medicaid changes would account for an increasing number of uninsured, eventually hitting 14 million. The rollback of the Affordable Care Act's Medicaid expansion would begin in 2020, cutting the number of people on the program. In addition, no states would be able to take up the expansion in the future, further dropping the number of potential Medicaid enrollees.

Premiums go up, then down (but not for everyone)

The CBO's report shows that premiums in the individual insurance market would increase first, then decrease, ending up 10 percent lower than they would be under the current law in 2026. That's because young and healthy people would likely drop out early on, bringing premiums up. But the mix of people would eventually shift younger, pushing premiums down younger people tend to be healthier, and therefore cost less to insure. In addition, insurers will not have the same requirements for sharing the cost of certain benefits.

Republicans are applauding this. In fact, Budget Director Mick Mulvaney said this week that while he (and others in the administration) are shrugging off the CBO's findings as unreliable, this was one part of the report he believed:

"Everyplace else where the market is allowed to function, quality goes up and costs go down," he said, "and I think if you look for something the CBO may have gotten right in this report, it's that the premiums are actually going to come down in cost."

But it wouldn't work out the same for everyone. Many younger Americans would end up paying less, as would people young and old alike making middle-to-upper-middle incomes, according to the CBO analysis. However, premium costs would hit many low-income adults hard, particularly older low-income adults.

A 64-year-old making $26,500 a year would pay around $1,700 in premiums right now. Under the proposed changes, that person would pay $14,600, more than eight times more.

One big reason for that is that the new health care bill would change the gap between what young and old people will pay for their premiums. Currently, insurers can charge older enrollees three times what they charge someone younger. The Republican plan would up that from 3-to-1 to 5-to-1.

Big leaps in the poor and uninsured

The uninsurance rate will increase among the poor and nonpoor alike. But it appears it would grow the most more than doubling among older, low-income insurance buyers. Not coincidentally, that's also the group that would see its cost of insurance climb in a huge way.

The uninsurance rate among people ages 50 to 64 who are below 200 percent of the federal poverty level would leap from 12 percent uninsured to 30 percent.

Smaller deficit

Under the Republican bill, the deficit would shrink by $337 billion over 10 years, or $33.7 billion per year on average.

That reduction would mainly come from the Medicaid rollback and, to a lesser degree, the end of Affordable Care Act subsidies. Both of those changes would reduce spending by a little more each year.

All told, Medicaid savings will come out to $880 billion over the decade. That reflects the massive changes that will be made to Medicaid under the plan. Existing enrollees could stay on, but the expanded income threshold that the Affordable Care Act set would move. That would mean fewer people could sign on in the future. Not only that, but the new plan would cap how much the federal government spends on Medicaid, making it much more expensive for states to keep up current levels of coverage.

A smaller deficit may make fiscal conservatives happy, but it's altogether a modest shift. The deficit reduction here averages out to $33.7 billion per year. For comparison, the 2016 deficit was $587 billion.

Read more:
5 Charts That Explain The CBO Report On The Republican Health Plan - NPR

New York Times

Winter Storm, Republican Party: Your Tuesday Evening Briefing New York Times 1. Snow, sleet and ice slammed the eastern United States, but New York City escaped the worst of the powerful late-winter storm. Most of the city got four to six inches of snow, as much of it gave way to sleet. Far more snow fell north and west of the ...

Excerpt from:
Winter Storm, Republican Party: Your Tuesday Evening Briefing - New York Times

The Trump administration and House Speaker Paul D. Ryan are defending the Republican bill to supplant the Affordable Care Act, while facing criticism from Democrats and fellow GOP lawmakers. (Bastien Inzaurralde/The Washington Post)

Depending on which outside analyst you ask, between 6 million and 15 million people would probably lose insurance coverage if the Republican alternative to the Affordable Care Act passes Congress and is signed into law.

Or, actually, lets revise that. Depending on whom you ask in Republican leadership, the real number is more like zero or, perhaps, negative: People will gain coverage under the proposal.

As part of the Republican push for the American Health Care Act, administration officials joined the Sunday political talk shows to offer their thoughts about the future of coverage. With analysis of the American Health Care Act from the nonpartisan Congressional Budget Office looming, the officials predictions about the effects of the bill were far rosier than the analysis offered by the Brookings Institution (15 million losing coverage over 10 years) or Standard & Poors (6 million to 10 million by 2024).

Heres what they said.

Health and Human Services Secretary Tom Price: Coverage will increase. Appearing on NBCs Meet the Press, Price offered his vision for what success of the bill looked like.

Success, its important to look at that, he said. It means more people covered than are covered right now at an average cost that is less. I believe that we can firmly do that with the plan that weve laid out there.

Last year, Price, then a member of the House, offered an Affordable Care Act replacement bill that was vetoed by President Barack Obama. An analysis of that bill from the Congressional Budget Officefigured that 18 million people would lose coverage under that plan.

Price also told host Chuck Todd that nobody will be worse off financially under the proposal.

Gary Cohn, chief economic adviser to President Trump: Coverage will be maintained. On Fox News Sunday, Cohn was pressed by host Chris Wallace to explain whether the administration would continue to back the American Health Care Act if the Congressional Budget Office also were to predict that millions would losecoverage. He played Cohn a clip from 2015 of Trump on 60 Minutes.

I am going to take care of everybody, Trump said then. I dont care if it costs me votes or not. Everybodys going to be taken care of much better than theyre taken care of now. He repeated a similar claim shortly before his inauguration, telling The Washington Post that [w]ere going to have insurance for everybody. There was a philosophy in some circles that if you cant pay for it, you dont get it. Thats not going to happen with us.

Twenty million people gained coverage, have health insurance coverage now who didnt have it before Obamacare. Are some of them going to lose coverage, Wallace asked, because, one, youre going to end over a period of years the Medicaid expansion and, two, the tax credits are not going to provide as much help as the subsidies did to people who cant afford coverage.

Chris, we dont think so, Cohn replied. If youre on Medicaid, youre going to stay on Medicaid.

But not the expanded Medicaid, Wallace replied.

If youre on Medicaid, youre going to stay. The expansion is not going to change. There is a roll-off period, there is a period of transition, and were very confident that the period of transition is going to work, Cohn said.

House Speaker Paul D. Ryan: People will make their own choices. Ryan appeared on CBSs Face the Nation with John Dickerson. After Ryan (R-Wis.) offered his prediction that the Congressional Budget Office would estimate that coverage would drop, Dickerson asked how many people the speaker thought might lose coverage.

I cant answer that question. Its up to people, he said. Heres the premise of your question. Are you going to stop mandating people buy health insurance? People are going to do what they want to do with their lives because we believe in individual freedom in this country.

Its not our job to make people do something that they dont want to do, he added later. It is our job to have a system where people can get universal access to affordable coverage if they choose to do so or not.

Its worth noting that this contrasts with what the official website for the Republican repeal effort states. Linked prominently from Ryans official House website, the public American Health Care Act page explicitly states in a FAQ that millions wont lose coverage.

Budget Director Mick Mulvaney: Coverage isnt the important thing. On ABCs This Week, host George Stephanopoulos asked Mulvaney repeatedly whether Trumps pledge to cover everybody could be upheld. Mulvaney demurred, instead insisting that the coverage itself would be more affordable. It helps people get health care instead of just coverage, he said.

After the pair had gone back and forth a few times, Stephanopoulos asked specifically about what would happen if the Congressional Budget Office predicted that millions of people would lose coverage. Mulvaney, like press secretary Sean Spicer last week, pointed out that the officesestimates of coverage under the Affordable Care Actwere off, predicting more coverage than was actually seen.

If says that fewer people are going to be covered, youll simply reject that? Stephanopoulos asked.

If the CBO was right about Obamacare to begin with, there would be 8 million more people on Obamacare today than there actually are, Mulvaney replied. I love the folks at the CBO. They work really hard. They do. But sometimes we ask them to do things theyre not capable of doing, and estimating the impact of a bill of this size probably isnt the best use of their time.

It sounds like youll reject it, Stephanopoulos said, inadvertently summarizing more than just Mulvaneys response.

See original here:
Millions might lose health coverage? Not to hear Republican leaders tell it. - Washington Post

Congress

Nevada Sen. Dean Heller raises numerous objections to the House bill, according to audio obtained by POLITICO.

By Burgess Everett

03/12/17 06:46 PM EDT

Sen. Dean Heller panned House Speaker Paul Ryan's bill to repeal and replace Obamacare during a closed meeting with constituents on Saturday, according to audio obtained by POLITICO.

The remarks by Heller, the most vulnerable GOP senator on the ballot next year, are another sign of the difficult prospects the House bill faces in the other chamber. Already, more than a half-dozen senators have criticized the bill, and Republicans can afford to lose only two votes.

Story Continued Below

The Nevada senator has been quiet about the GOPs efforts to dismantle the Affordable Care Act as he prepares to run for reelection as the only Republican incumbent from a state Hillary Clinton won. But Heller raised significant issues to state Republicans and senior center residents about how the bill would affect the states Medicaid population, even as he declined to say that health care is a fundamental right.

Ive heard a lot of people say that every American has a right to an automobile, Heller said to guffaws from liberal attendees, who frequently challenged him and at one point called him a liar. Do I believe that all Americans should have access to health care? Absolutely, I do.

Still, Heller took a far softer tack than the laws staunchest opponents, frequently speaking of making changes to Obamacare rather than eviscerating the law as some Republicans say they will do. He made no commitment to support the House-led effort to repeal the law, which could come before the Senate this month.

Not everything in the Affordable Care Act is bad, Heller told the crowd in Henderson, a suburb of Las Vegas, as protesters demonstrated outside. As we move forward and take a look at some of these changes and whats occurring, I think we ought to embrace whats good in the Affordable Care Act.

His strategy on Obamacare shows the tightrope Heller is walking in a state that's trending Democratic but has a strong presence of conservative activists. Heller was critical of Donald Trump in last year's election. At the Saturday event, he urged the president to keep his promise to enact a trillion-dollar infrastructure program and said having a safety net is a core responsibility of government.

But the focus was mostly on how Heller handles Obamacare repeal. Nevada has nearly 300,000 people who have obtained insurance through the ACA's Medicaid expansion, and the states GOP governor, Brian Sandoval, has warned against changing it. The House bill would keep the expansion through 2019 before winding it down, although some conservatives want to begin gutting it earlier.

Theyre talking about 2020, now theyre talking about making the changes in 2018, Heller said. Thats not enough time for Nevada to adjust. We need time to adjust. I want to move that thing up four or five years," he added, referring to a longer delay.

Heller also said he opposed the bills preservation of the so-called Cadillac tax on high-cost insurance plans. Heller and Sen. Martin Heinrich (D-N.M.) have sought to kill the tax for years.

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My argument with the Republicans is if were going to make the changes, dont repeal the Affordable Care Act so you can keep all the taxes. I think thats unfair and I dont think thats a responsible way to move forward, Heller said. The House bill does eliminate some taxes on wealthy people.

Hellers comments underscore the difficult prospects the House measure faces in the Senate should it make it to the chamber. The Nevada senator said he was urging Vice President Mike Pence and Senate Majority Leader Mitch McConnell to allow the Senate to make significant changes to the bill. Conservatives in both chambers have knocked the plan as "Obamacare-lite," and centrists are concerned about its rollback of the Medicaid expansion.

Heller's criticisms of the effort have been more under the radar. He faced protesters outside the Henderson event for avoiding public town hall events that have turned into forums for liberal activists. Heller has instead focused on private events and "tele-town halls" in which constituents can call in. Heller also rarely speaks to reporters in Washington, often using routes in the Capitol to avoid the media.

Asked by one person Saturday why he wont have an open town hall meeting, Heller responded: Did anybody force you to come today? This is a town hall meeting. That remark led to shouting matches between Hellers supporters and his hecklers, with one organizer telling attendees they are acting like children.

It wasnt the only moment of hostility. Heller claimed at one point that the economy was entirely stagnant under former President Barack Obama despite steady growth after the recession.

It's been eight years, eight years since I've heard a treasury secretary talk about economic growth, Heller said. They never talked about economic growth. You know what? We didn't have economic growth for the last eight years."

A woman shot back: Liar, liar pants on fire. Officials at the event then tried to remove her, according to the audio.

Heller ended the exchange with this response: I want to thank both Republicans and Democrats for being here today.

Indeed, the Nevada senator offered something to liberals and conservatives as part of his balancing act. He said he supports Neil Gorsuchs nomination to the Supreme Court and defended a recent vote to reverse regulations that required the Social Security Administration to flag people with mental illness for gun-sale background checks. Heller said he does not believe mentally ill people should be able to buy weapons, but also said that people can recover from mental illness and be able to keep their Second Amendment rights.

And when asked about veterans health care, Heller touted an Obama-era program that allows some veterans to seek health care closer to home.

Bernie Sanders will tell you that he and I teamed up to make these necessary changes for our veterans, Heller said. Sanders will be the first to tell you: That when I gave him my word, I stuck with it.

See original here:
Another key Republican senator knocks GOP Obamacare plan ... - Politico

Republican Sen. Tom Cotton said GOP members of the House should not "walk the plank" by approving the Republican health care bill, warning that it could cost the party the House majority and put the entire GOP agenda at risk.

"I would say to my friends in the House of Representatives with whom I serve, 'Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote," Cotton told ABC News chief anchor George Stephanopoulos.

The Arkansas senator went further, saying on "This Week" Sunday that Republicans are in danger of losing their House majority if they approve the GOP health measure, called the American Health Care Act, proposed last week by House Republican leaders and endorsed by the White House.

Cotton has been critical of the legislation that congressional GOP leaders put forward to repeal and replace the Affordable Care Act, known as Obamacare.

"Im worried it could make it worse in some ways, that insurance rates could go up and Americans could have even less control over their health care systems," Cotton told ABCs chief White House correspondent Jonathan Karl Thursday.

On "This Week," Cotton said, "I just do not think that this bill can pass the Senate, and therefore I think the House should take a pause and try to get as close as we can to a good result before we send it to the Senate."

When pressed by Stephanopolous to clarify if he was suggesting that House Republicans who vote for the bill "are going to pay the price without getting any benefit," Cotton noted that Republicans have other agenda goals in addition to health care reform.

"We have majorities in the House and the Senate and the White House not only to repeal Obamacare and get health care reform right, but to reform our taxes and our regulations and build up our military and accomplish many other things," Cotton said. "And I don't want to see the House majority put at risk on a bill that is not going to pass the Senate."

"That's why I think we should take a pause, try to solve as many of the problems on both Medicaid and the individual insurance market in this bill in the House and then allow the Senate to take its work up," Cotton said. The bill probably can be fixed, but its going to take a lot of carpentry on that framework."

Read more from the original source:
Republican senator: GOP risks losing House majority if health bill approved - ABC News