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CBO: 22 million more would be without health insurance over next decade under Senate bill

CBO score
CBO projects Senate health bill would drive up number of uninsured 02:18

Twenty-two million more people would be without health insurance over the next decade under Senate Republicans' plan to repeal and replace Obamacare, according to an analysis released Monday by the nonpartisan Congressional Budget Office.

Under the House-passed bill, 23 million more people without health insurance over the same time period, CBO projected in May.

The budget scorekeeper said Monday that next year, 15 million more people would be uninsured under the Senate's measure because Obamacare's individual mandate that forces a penalty on the uninsured would be eliminated.

The Senate measure, Better Care Reconciliation Act (BCRA), would leave 49 million people uninsured in 2026 compared to 28 million people uninsured by that year under Obamacare. And by 2026, there would be 15 million fewer Medicaid enrollees.

Average premiums under the bill would increase in the nongroup market before 2020 and decrease after that, CBO said. Average premiums for single people under benchmark plans, for example, would be about 20 percent higher next year and 10 percent higher in 2019, compared to current law. By contrast, CBO said that in 2020, average premiums for single people under benchmark plans would be about 30 percent lower than under current law. By 2026, the analysis projects such premiums will be 20 percent lower than under Obamacare.

While average premiums will eventually drop, CBO said Monday that the Senate bill would lead to higher out-of-pocket spending for people and fewer covered benefits.

The Senate bill would also reduce the federal deficit over the next 10 years by $321 billion. The largest savings would stem from Medicaid cuts, with spending on it dropping by more than a quarter in 2026.

The cost estimate comes days before the Senate is expected to vote on the measure -- just before lawmakers leave Washington for their week-long July 4 recess. And even with the clock ticking, leadership has not yet secured enough votes to pass it.

They need 51 votes to pass the 142-page measure, which means they need at least 50 senators to support it, with Vice President Mike Pence as the tie-breaking vote. Assuming all Democrats vote against the bill, more than three Republican "no" votes would kill the legislation. Five Senate Republicans have so far publicly said they oppose the current form: Ted Cruz of Texas, Mike Lee of Utah, Rand Paul of Kentucky, Dean Heller of Nevada and Ron Johnson of Wisconsin. Johnson and Heller have suggested it will be challenging to persuade them to vote in favor.

Sen. Susan Collins, R-Maine, who has expressed strong concerns about the measure, had been waiting for the CBO score before making a decision about her position.

The 142-page measure, released Thursday, would end Obamacare's penalties for people who don't buy insurance, replacing them with a penalty for lapsed coverage; and it would cut back an expansion of Medicaid, but would keep more protections for people with pre-existing conditions, compared to the House-passed bill. It would provide tax credits, based on income, age and geography, which would make more money available to lower-income recipients to help them buy insurance. This differs from the House bill, which tied its tax credits only to age. Obamacare taxes would be repealed under the bill. The Senate bill would provide for expanded tax-free Health Savings Accounts, and it would also eliminate federal funding for Planned Parenthood for one year.

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