(Bloomberg) — Changes Republicans made to H.R. 1628, the American Health Care Act bill, to help pass it through the House would undermine insurance markets and result in millions more people without insurance, the Congressional Budget Office said, an assessment that will likely complicate the GOP's effort to change the Affordable Care Act system.
The CBO, which acts as Congress's actuarial arm, said Wednesday that the legislation would increase the number of uninsured by 23 million. The changes also mean that in some states, older or sicker people might not be able to afford health insurance plans. And women might be forced to pay $1,000 a month to buy coverage for maternity care.
The American Health Care Act bill passed the House earlier this month without a score from the CBO. The agency's harsh assessment is likely to dampen the bill's already grim prospects in the Senate, where GOP lawmakers possess only a slim majority.
"It's informative to know the estimated impact of the House health care bill — but the Senate is writing its own," said Sen. Lamar Alexander, a Tennessee Republican.
Sen. Bill Cassidy, a Louisiana Republican, said the House bill failed to meet what he called the "Jimmy Kimmel Test," a reference to the late-night talk-show host's infant son, who was born with a heart defect, and the idea that any new health law should provide generous-enough insurance to cover critical medical needs.
"Congress's focus must be to lower premiums with coverage which passes the Jimmy Kimmel Test. The AHCA does not," he said in a statement. His Republican colleague, Sen. Susan Collins of Maine, likewise said that the GOP bill would "disproportionately affect older, low-income Americans."
Deficit Reduction
The House GOP's bill would reduce the deficit by $119 billion over 10 years, CBO said Wednesday. That figure is $32 billion lower than the estimated deficit reduction under an earlier version of the legislation.
There are concerns that the House legislation could cause procedural obstacles for both chambers.
Under so-called reconciliation rules that let Republicans block Democrats' efforts to filibuster a vote, $1 billion of the $119 billion in savings have to fall under the jurisdiction of each of the two Senate committees that oversee the legislation, the Finance Committee, as well as the Health, Education, Labor and Pensions Committee. It may take weeks for that determination to be made. If the House bill doesn't pass that test, it could be sent back to the chamber for a re-vote.
GOP Amendments
Republicans in the House made several last-minute amendments to their bill to win over conservatives. The changes would allow states to apply for waivers to the Affordable Care Act's rules on what benefits must be covered by plans, and how much insurers can charge based on people's age.
While those changes helped gain votes, the CBO said the alterations would undermine protections for the sick and destabilize insurance markets for about a sixth of the U.S. population. The changes could also lead to healthy people buying cheaper policies and sicker people being shunted into more expensive plans or unable to afford coverage, according to the report.
"The agencies expect that premiums would be substantially higher than previously estimated for less healthy people in some states and somewhat lower for the healthier people in those states," the CBO said. Eventually, premiums could rise to the point that some plans would have no enrollment.
