CBO: PPACA Repeal Could Help Some, Hurt Some

January 06, 2011 at 07:00 PM
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WASHINGTON BUREAU — Repealing the Affordable Care Act could make the cost of large-group health coverage slightly higher and make the cost of individual coverage somewhat lower, according to the Congressional Budget Office (CBO).

The effects of repeal on the small group market are less certain but could make small group premiums slightly higher or slightly lower, CBO analysts estimate.

CBO analysts prepared the projections for House Speaker John Boener, R-Ohio, in response to the introduction of H.R. 2, the Job-Killing Health Care Law Act bill. The bill would repeal both components of the Affordable Care Act package — the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act.

The net impact of many different repeal-related changes would cause the small Douglas Elmendorf - Affordable Care Act repeal changes in group coverage costs, CBO analysts report.

In the individual market, the full price of premiums would be lower "mostly because the average insurance policy in this market would cover a smaller share of enrollees' costs for health care and a slightly narrower range of benefits," CBO Director Douglas Elmendorf says in a letter summarizing the analysts' findings on the budget impact of H.R. 2.

Even though individual premiums would be lower, the typical consumer in the individual market would pay more for coverage, Elmendorf says.

If the current Affordable Care Act provisions stay in place and work as the CBO analysts expect, "the majority of enrollees purchasing coverage in that market would receive subsidies via the insurance exchanges, and H.R. 2 would eliminate those subsidies," Elmendorf says.

The CBO analysts also say Affordable Care Act repeal might:

- Increase federal budget deficits by a total of about $145 billion over the 2012-2019 period. Over the 2012-2021 period, repeal could increase deficits by a total of about $230 billion, the analysts estimate.

- Increase the number of uninsured nonelderly people to 54 million, from 32 million.

- Cut the share of legal nonelderly residents with insurance coverage to about 83% in 2019, from 94% if the Affordable Care Act stays in effect.

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