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Less healthy, older Americans would pay more under GOP health bill

May 24, 2017 at 6:25 PM EDT
The Congressional Budget Office released its cost estimate for the American Health Care Act Wednesday, 20 days after the bill passed the Republican-led House of Representatives. The prognosis? About 23 million Americans are expected to lose their coverage by 2026. Lisa Desjardins joins Judy Woodruff to discuss the CBO’s projection.
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JUDY WOODRUFF: But, first, let’s go back to the health care battle and the new analysis that came out late today from the Congressional Budget Office of the GOP bill that passed the House of Representatives almost three weeks ago. It now sits with the Senate.

The CBO found that the House bill would lead to 23 million more people being uninsured by the year 2026 and it would reduce the deficit by about $119 billion over a decade.

Our Lisa Desjardins has been studying the numbers and watching the politics of all of this, and she joins me now.

So, Lisa, you have had a little bit of time to look at this. Essentially, what is different about the CBO’s look at this version of Republican health care from what the earlier version was?

LISA DESJARDINS: Well, in those top-line numbers, not much.

The changes that the Republicans made meant that there was an improvement in the number of people with insurance by one million people. That’s something Republicans were happy to see, but it’s not really very much.

Judy, I think, overall, the differences are in the individual effects here. We see from CBO a forecast that says under this Republican bill you would see a wide disparity, with the less healthy seeing much higher bills and also older people seeing much higher bills.

JUDY WOODRUFF: So, we know the Republicans were trying to do a number of things with this legislation to make it more palatable to more people to win not only approval in the House, but to win approval in the Senate. They were trying to get premiums down.

Talk about some of the changes they made and what the CBO is saying about that?

LISA DESJARDINS: The biggest change a lot of people would be familiar with is, they want to give states the ability to waive out of requirements called essential benefits.

These are things that say any health insurance must cover the basics. They want states to be able to waive out of that. They also want states to be able to waive out of requirement on preexisting conditions, allow insurers to charge more for the sick than they can now.

CBO looked at those potential waiver changes and what that mean for premiums. Let’s look at an example of what we’re talking about. First of all, a 21-year-old who’s making, say, $26,500, so, low-income — that is who this is targeted at — now that 21-year-old’s premium would be $1,700.

But under this bill in a state that waives out of those requirements, that 21-year-old would pay $1,250. That’s good for that healthy 21-year-old.

Let’s look now instead at a 64-year-old American paying $1,700 now. But, Judy, look at that. Under this GOP bill, with the waivers out of requirements, the CBO thinks that 64-year-old would see their premiums skyrocket. Essentially, what the CBO has found — and it’s going to vary market to market — is that the less healthy and older Americans would see more costs.

JUDY WOODRUFF: So, premiums are part of the story, but we know something else that the CBO was looking at was, frankly, the overall quality of health care under this new legislation.

LISA DESJARDINS: And this is such an important point.

We have talked about premiums. It’s sort of a buzzword in a way, almost. But CBO went deeper and said that, in some of these states with the waivers, premiums may go down for some people, but, overall, they think that health care costs could substantially increase, because what you’re getting are health insurance packages that cover a lot less.

So, if you’re sick, you might have a low premium, but you’re going to pay a lot more out of pocket. Also, Judy, I asked on a call I just got off of with the CBO about stabilization. Are these markets going to be stable?

They told me point blank they think there will be a stability problem in these waiver markets. They say some people may not be able to get premiums at all and it would take those markets back to the days before the Affordable Care Act.

Essentially, Judy, more of a gamble for Americans. You would able to pay less, but you would have much higher risk.

JUDY WOODRUFF: Sounds like this is going to be even more complicated than what the Republicans — it’s going to make what they sent over more complicated and make it challenging to get it passed.

LISA DESJARDINS: I don’t see any Republicans coming out with happy tweets or statements today. No, Democrats are talking about the CBO score, not Republicans.

JUDY WOODRUFF: Lisa Desjardins, following the story, thank you very much.

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