Up to 24 million could lose health cover if Obamacare replaced

Congressional Budget Office says Republican plan would reduce federal deficit by $337bn

Up to 24 million people stand to lose their health insurance within a decade under the Republican plan to repeal and replace Obamacare, a congressional agency has found.

In a much-anticipated report released on Monday the non-partisan Congressional Budget Office said that 14 million fewer Americans would be insured under the Republicans’ alternative Bill, a number which would rise to 24 million by 2026.

The analysis also found that the new proposal, known as the American Health Care Act would reduce the federal deficit by $337 billion over 10 years, a finding that is likely to be welcomed by Republicans. Likewise, premiums would be 10 per cent lower on average by 2026, though they would rise by 15 to 20 per cent in the first year.

But the prediction of a drastic fall in the numbers of Americans who are insured will increase pressure on US president Donald Trump and the Republican party to justify dismantling Barack Obama’s Affordable Care Act introduced seven years ago.

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Repealing and replacing Obamacare was a key refrain of the Republican party in the run-up to last year’s presidential election. The Republican replacement proposal which was unveiled last week is moving through the US legislative system at an accelerated pace, having been passed by two key house committees last week.

Resistance

The plan, which has been driven mostly by house speaker Paul Ryan, has faced resistance not just from Democrats, but from a core group of conservative Republicans who are concerned that its inclusion of a tax credit plan equates to a new federally-funded subsidy. The White House has engaged in a charm offensive over the last week to convince wavering Republicans to back the Bill.

The Congressional Budget Office (CBO) provides independent analysis to Congress of the budgetary impact of major legislative proposals. It is currently headed by a republican nominee, Keith Hall, who was appointed in 2015. Democrats staunchly criticised the decision of Republican representatives not to cost or demand CBO analysis before unveiling their Bill. The CBO’s analysis had been expected to be negative, and throughout the weekend several senior Republicans have sought to downplay the agency’s significance. Mr Trump’s budget director Mick Mulvaney told ABC on Sunday: “If the CBO was right about Obamacare to begin with, there’d be eight million more people on Obamacare today than there actually are. . . . Sometimes we ask them to do stuff that they’re not capable of doing.”

Call for withdrawal

Democrats were quick to seize on the report on Monday, calling for the legislation to be withdrawn. Congressman Joe Crowley said the legislation should be ”immediately discarded”, noting that the CBO estimate was far higher than expected and accusing Republicans of rushing their healthcare bill through committee during two middle-of-the-night mark-ups [amendments].

Recent polls have shown an increase in support for Mr Obama’s signature healthcare policy which is credited with extending health insurance to millions of Americans.

Among the main changes contained within the Republican plan are the removal of the obligation for everyone to buy health insurance and changes to the current system of tax credits and medicare eligibility.

Meanwhile, President Donald Trump signed a new executive order on Monday designed to reorganise the structure of federal agencies in a bid to downsize government agencies and cut government waste – a key campaign promise. Announcing the news, Mr Trump said a “thorough examination of every executive department and agency” would begin in order to find out “where money is being wasted [and] how services can be improved”. It is not yet clear which government agencies will be targeted. The proposal will also go to Congress for approval, he said.

Suzanne Lynch

Suzanne Lynch

Suzanne Lynch, a former Irish Times journalist, was Washington correspondent and, before that, Europe correspondent