Office: If no new law, 18 million lose insurance

Health act repeal seen raising premiums 25% in first year

In this Jan. 13, 2017 file photo, President-elect Donald Trump speaks with reporters in the lobby of Trump Tower in New York.
In this Jan. 13, 2017 file photo, President-elect Donald Trump speaks with reporters in the lobby of Trump Tower in New York.

WASHINGTON -- Insurance premiums would soar for millions of Americans and 18 million more would be uninsured in just a year if Republicans scuttle much of the Patient Protection and Affordable Care Act without a replacement, Congress' budget analysts said Tuesday.

Spotlighting potential perils for Republicans, the analysts' report immediately became a flashing hazard light for this year's effort by Donald Trump and GOP lawmakers to annul the health care law and -- in a more complicated challenge -- institute their own alternative.

Republicans have produced several outlines for how they would redraft the 2010 statute, but they've failed to unite behind any one plan. Indeed, President-elect Trump and GOP congressional leaders have at times offered clashing descriptions of a top goal, so eventual success is hardly guaranteed.

Tuesday's evaluation came from the nonpartisan Congressional Budget Office, joined by Congress' Joint Committee on Taxation.

Together, they analyzed a Republican-written bill, vetoed by Obama last January, that would have erased major parts of the health care overhaul. Those included tax penalties for people who fail to buy insurance and for larger companies that don't cover workers, federal subsidies to help consumers buy policies on the law's online marketplaces and an expansion of Medicaid coverage for low-income people.

The new report said that under such a measure, premiums for individual policies -- excluding the coverage many workers get from employers -- would swell by up to 25 percent the first year after enactment and double by 2026. The number of uninsured would reach 32 million over the decade, the analysts said.

However, Republicans say there's a big difference between that 2016 bill and this year's plan: Last year's version would not have replaced the Affordable Care Act with a GOP alternative, while Republicans insist replacement will be an integral part of their new health care drive.

Citing that difference, Donald Stewart, spokesman for Senate Majority Leader Mitch McConnell, R-Ky., said the report "assumes a situation that simply doesn't exist and that no one in Congress advocates." AshLee Strong, spokesman for House Speaker Paul Ryan, R-Wis., called the estimates meaningless because they ignore plans for legislation and regulatory actions by the incoming Trump administration that would revamp how people could obtain coverage.

"Nonpartisan statistics don't lie," countered Senate Minority Leader Charles Schumer, D-N.Y., who said the report showed Republican plans to void Obama's overhaul "will increase health care costs for millions of Americans and kick millions more off of their health insurance." House Minority Leader Nancy Pelosi, D-Calif., said it illustrated that the GOP effort "will be nothing less than a nightmare for the American people."

Trump seemed to complicate the GOP drive last weekend when he told The Washington Post that a coming Republican plan would provide "insurance for everybody." In contrast, some congressional Republicans have described their goals more modestly, saying they will offer "universal access."

The Congressional Budget Office's analysis has particular weight because Republicans have cited last year's bill as a starting point for their drive this year to erase the Affordable Care Act.

For Senate procedural reasons, that 2016 GOP bill also had to leave intact some mandates the health care law has imposed on insurers. Those include requiring coverage of certain services and barring insurers from denying policies to sick people or charging them higher rates.

Those same Senate procedures could make it hard for Republicans to erase the mandates this year, too. That would make things tough for the GOP because those insurance requirements tend to drive insurers' costs higher, and leaving them intact while other parts of Obama's statute are erased could wreak havoc.

The Budget Office said that, under the 2016 Republican bill, most reductions in the number of insured people would come from annulling the tax penalties the Affordable Care Act imposes on people who don't buy policies: Some people would simply drop out if not forced to buy insurance.

Information for this article was contributed by Ricardo Alonso-Zaldivar of The Associated Press.

A Section on 01/18/2017

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