"In 2026, an estimated 51 million people under age 65 would be uninsured, compared with 28 million who would lack insurance that year under current law," the CBO said. "[This increase in the uninsured] would be disproportionately larger among older people with lower income."
The legislation would reduce the federal deficit over the period of 2017 to 2026 by $119 billion, which the CBO noted is $32 billion less than the savings the U.S. House of Representatives Committee on Rules posted on its website on March 22. Most of the savings would come from reductions to Medicaid and the bill's replacement of the Affordable Care Act's individual insurance subsidies with tax credits.
Other effects of the bill would include the following:
- $834 billion in cuts to Medicaid
- Savings of $665 billion that would come from eliminating in 2020 the ACA's subsidies for individual health insurance
- Premium increases in 2018 and 2019, after which there would be variation by state, depending on whether the state opts out of the ACA's essential health benefits requirement; in such states, premiums could decrease by 20% over a decade compared to current law
- Premium changes according to age: Premiums for older people could be five times higher than for younger people in many states
The CBO also estimated that in 2020, one-sixth of the population would live in areas with unstable insurance markets, which could make it difficult to find healthcare, especially for those with pre-existing conditions.
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