Democrats have some new ammo in their fight to save the Affordable Care Act (ACA) as the Congressional Budget Office (CBO) released its score of the Republican’s plan to repeal and replace key parts of the Affordable Care Act (ACA). The “score” is a report issued by the CBO which outlines the anticipated financial and economic impact of proposed bills, and the score of the American Health Care Act (AHCA), which is the formal name of the repeal and replace bill, had some troubling news for Republicans.

 

Most notably, the scoring estimates that 14 million more Americans would become uninsured in 2018 if the AHCA were signed into law. The report indicates this swift increase in the number of uninsureds would mostly be attributed to the elimination of the Individual Mandate and voluntary terminations of coverage due to high premiums. 

 

By 2026, the CBO score estimates 52 million Americans in total would be uninsured, compared to an estimated 28 million under current law, a difference of 24 million in favor of the ACA. This stems largely from cuts and changes to the Medicaid program, per the report. 

 

While these numbers will be hard to sell to the public, the duo of Paul Ryan (Speaker of the House) and Tom Price (Health and Human Services Secretary) are out to discredit the report. Ryan and Price, who are the two primary Republicans leading efforts to repeal and replace the ACA, say the information in the CBO report is not all bad, and it’s not all true. 

 

The scoring does estimate the AHCA would reduce federal deficits by $337 billion over the next decade. Republicans, who proclaim to be a fiscally responsible party, can generally buy into those kinds of savings. Ryan and Price also point out that the CBO’s score is largely based on assumptions, some of which may be inaccurate or not even known. 

 

For example, a stated goal with repeal and replace is to give control to states in determining what benefits must be covered under a health insurance plan. That decision, at the state level, could and probably would vary throughout the country. It would also impact premiums and plan designs which in turn should impact how many people get coverage. 

 

Ryan and Price also don't want you to forget about the inaccuracies from previous CBO scores, which they say have been largely off in predicting how many people would gain coverage through ACA exchanges. For instance, the CBO had originally estimated 21 million Americans would be covered by a plan purchased on an ACA exchange in 2016, but the actual number of enrollees was about half that number. There’s clearly a lot of wild cards in play, and a lot them aren’t known yet. 

 

Nonetheless, it’s likely back to the drawing board for Republicans. It’s expected they’ll make some tweaks to the AHCA now that the CBO score is in. Until that time, the ACA continues to be the law of the land.