Jay Bookman

Opinion columnist and blogger with The Atlanta Journal-Constitution, specializing in foreign relations, environmental and technology-related issues

Opinion: Highlights (i.e., lowlights) of CBO health analysis


The Congressional Budget Office and Joint Committee on Taxation have released their analysis of the Senate GOP's health-care proposal.

Bottom line?

It ain't pretty.

OVERALL IMPACT

"The Senate bill would increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law.... By 2026, an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law."

IMPACT ON OLDER AMERICANS

"CBO and JCT expect that this legislation would increase the number of uninsured people substantially. The increase would be disproportionately larger among older people with lower income — particularly people between 50 and 64 years old."

MEDICAID SPENDING CUTS

"The largest savings would come from reductions in outlays for Medicaid — spending on the program would decline in 2026 by 26 percent in comparison with what CBO projects under current law.... Enrollment in Medicaid would be lower throughout the coming decade, with 15 million fewer Medicaid enrollees by 2026 than projected under current law."

IMPACT ON LOWER-INCOME AMERICANS

"Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income — also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

"The net premium of a silver plan for a 40-year-old would be about 15 percent of their annual income, and the deductible would be more than one-third of their annual income."

IMPACT ON DEDUCTIONS

"Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law."

IMPACT ON PLANNED PARENTHOOD BAN

"To the extent that access to care would be reduced under this legislation, services that help women avoid becoming pregnant would be affected. The people most likely to experience reduced access to care would probably reside in areas without other health-care clinics or medical practitioners who serve low-income populations. CBO projects that about 15 percent of those people would lose access to care. Because the Medicaid program pays the costs of about 45 percent of all births, CBO estimates that the additional births stemming from the reduced access under this legislation would add to federal spending for the program. In addition, some of those children would themselves qualify for Medicaid and possibly for other federal programs."


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About the Author

Jay Bookman writes about government and politics, with an occasional foray into other aspects of life as time, space and opportunity allow.