The GOP’s effort to replace ObamaCare’s insurance markets with a health insurance exchange and tax credits is moving along, but the party is still struggling to sell the idea as an affordable alternative to Obamacare.
A report from the Congressional Budget Office (CBO) on Tuesday says the Senate version of the legislation would leave 23 million fewer people insured by 2026 than would be covered by the Affordable Care Act.
But the CBO also found that repealing the individual mandate, which requires people to purchase insurance, would save the federal government about $880 billion over a decade, or $6,800 per family.
The Senate bill would instead provide subsidies for people to buy insurance through state exchanges, while providing a refundable tax credit for families who buy their own coverage.
That money could be spent to lower the tax burden for middle-class families.
The CBO estimates that the Senate bill will lead to 13 million fewer uninsured people in 2026, as well as 12 million fewer in the next decade.
The GOP would need to find $1.4 trillion in new revenues to make up for the lost coverage over the next 10 years.
The report comes as Democrats and moderate Republicans have sought to put forward alternative ideas to replace the ACA, which passed in 2010 and was widely regarded as a success.
The Republican plan would be the first in the Senate to include the tax credits as part of the law.
It’s likely to face a difficult road in the GOP-controlled House of Representatives, where moderate Republicans are unlikely to approve a repeal bill that contains tax credits.
The nonpartisan Congressional Budget Board says the Republican plan will increase the deficit by $321 billion over 10 years and result in 22 million more uninsured people by 2027.
It also says that it would cost the federal budget $1,050 per family in 2027, more than double what it costs to insure one person for every $10,000 in income.
The Congressional Budget Council’s Michael Cannon-Brookes, who authored the report, said the GOP plan would lead to a greater deficit, but also said it would result in a smaller increase in federal spending.
“What we do know is that, over the long term, the CBO estimates, the Republicans plan will reduce the deficit and increase federal spending, but would result a larger increase in the federal debt than under current law,” Cannon-Rowes said.
“If you assume that they were to replace Obamacare’s individual mandate with a refunding tax credit, then the CBO says that the bill would increase the debt by $1 million by 2037.”
Cannon-Stokes said the CBO did not make a comparison of the GOP replacement plan with the Affordable Health Care Act, which was the main plank of President Donald Trump’s health care law.
Cannon-Browns office did not immediately respond to a request for comment.
Democrats have been pressing Republicans to take a more realistic approach to the replacement.
House Minority Leader Nancy Pelosi said Tuesday that the GOP proposal “would result in an increase in debt and would lead us to a debt-deficit of $19 trillion over the decade.
That’s the reality.”
She said that while she was “totally supportive of the Affordable Affordable Care Law,” the GOP bill was not “pro-growth.”
“We can’t just cut taxes and then get back on track,” Pelosi said.
House Speaker Paul Ryan also expressed skepticism about the GOP effort to repeal the individual mandates in a Tuesday speech, saying it was “inappropriate” to suggest that the legislation will lead the country toward debt crisis.
“I don’t know if it’s a good idea, or a bad idea,” Ryan said.