- The CMS Office of the Actuary estimates the American Health Care Act (AHCA) would result in 12.6 million people uninsured, far below the nearly 24 million estimate from the Congressional Budget Office (CBO). The actuary analysis also shows the bill reducing federal spending by $328 billion, more than double the CBO projection.
- The report points to a few potential detriments from a key theme in the AHCA of turning more regulation to the states, including a “possibly failing individual market” and premiums that “would become unaffordable.”
- Meanwhile, President Donald Trump, in a bizarre turnaround that caught other Republicans by surprise, said the House version of the bill that passed last month, is “mean” and too stingy with premium subsidies, Politico reported.
The analysis from the actuary differs significantly from the CBO’s because the agencies came to different conclusions about the effects of various provisions, such as eliminating the individual mandate and phasing out Medicaid expansion. Both reports cautioned that estimates for the bill are particularly difficult because of many unknowns, such as how employers, payers and states would respond to aspects of the legislation.
It’s a small bit of not-so-bad news for the GOP as the Senate aims to pass its own version of the bill by the July 4 holiday break. But debates among Senate Republicans on the timing of Medicaid changes and protection for people with pre-existing conditions are happening entirely behind closed doors. Democrats have frequently criticized the process, as no public hearings have been scheduled and lawmakers say they don’t intend to release the text of the bill before a vote.
The latest report doesn't comment on the current stability of the ACA exchange markets. With one week before the payer deadline for deciding participation, many insurers are pulling out. They mostly blame lack of clarity on cost-sharing reduction payments, which the White House and Congress have refused to say will continue. A few key payers are remaining in a least some markets, however, and Iowa is attempting to patch up its market with an $80 million infusion from the federal government.