CBO Gives Unfavorable Score to American Health Care Act

The Congressional Budget Office (CBO) scored the latest version of the Republican-sponsored American Health Care Act (AHCA), finding that, though it would save the federal government billions of dollars over the next decade, it would leave 23 million Americans without health insurance.

A revised version of the bill (which would replace the Affordable Care Act [ACA]) was passed by the U.S. House of Representatives through a special route to avoid filibuster in the U.S. Senate on May 4 – before the CBO released its report.

Authors of the report found that the bill would reduce the government deficit by $119 billion in the next 10 years through savings that would come from cuts to Medicaid and eliminating tax credits for middle-income insurance buyers. The costs of health-insurance premiums are projected to drop by 10 to 30 percent after 2020, but the CBO attributes this decline to the more limited scope of coverage. Although average premiums would be lower, the costs of caring for older and sicker patients will increase.

Before the implementation of the ACA, the number of uninsured Americans was 57 million, but dropped to 28.2 million in 2016. If the American Health Care Act becomes law, this number is expected to increase to 41 million in 2018 – and to continue to climb. This includes a projected 14 million Medicaid beneficiaries who will lose their coverage.


Older individuals with lower incomes will be the most severely affected by the loss of insurance, according to the CBO analysis. Americans who live in rural areas, where there are already few options for purchasing health insurance, would also be particularly vulnerable. “The agencies estimate that about one-sixth of the population resides in areas in which the nongroup market would start to become unstable beginning in 2020,” the authors of the report wrote, likely a result of states choosing to waive certain consumer protections included in the ACA – including covering essential health benefits.

Sources: The New York Times, May 24, 2017; The Los Angeles Times, May 23, 2017.