WASHINGTON (CN) – The last-ditch Republican effort to repeal the federal health care law would result in “millions” more people without “comprehensive” health insurance, a report released Monday by the nonpartisan Congressional Budget Office says.
The report is not as extensive as analyses of Republican’ previous health care plans, as the CBO did not have enough time to delve into specific coverage losses and estimates. Senate Republicans face an end-of-month deadline to pass their latest effort using the reconciliation process to bypass Democratic support.
The latest bill, referred to as Graham-Cassidy-Heller-Johnson after its sponsors, would lower the number of people with health insurance “by millions” because it would reduce Medicaid spending by $1 trillion over the next decade, as well as cut federal subsidies and eliminate the Patient Protection and Affordable Care Act’s requirement that most people buy health insurance, according to the CBO.
The report is an analysis of an earlier version of the bill, as its sponsors have made changes recently in an effort to woo GOP holdouts.
The Graham-Cassidy bill, sponsored by Sens. Lindsey Graham, R-S.C., Bill Cassidy, R-La., Dean Heller, R-Nev., and Ron Johnson, R-Wis., would take the federal money spent on the Affordable Care Act, which is also known as Obamacare, and give it to states as block grants.
The block grants given to states would be $230 billion less than what the CBO projected the federal government would spend on subsidies from 2020 to 2026, and as a result the bill would cut the deficit by $133 billion.
States could then use the money to set up their own insurance programs, though the expansion of Medicaid included in the Affordable Care Act would be repealed in 2020 and the way states are reimbursed under the program would change. In the end, the bill would shift money from states that chose to expand Medicaid to states that did not, according to the CBO report.
States would also be able to receive waivers from certain insurance regulations, and the CBO estimated most would take the opportunity to do so, in part because the insurance markets would become unstable if the current regulations remained in place with lower subsidies.
The report does not go deeply into what states would do with the increased flexibility, but does say the office has started the work on that deeper analysis.
“The flexibility afforded by the new block grants would allow states to experiment with different ways to cover health care costs,” the report states. “CBO and JCT expect that states would learn from one another, and over time, they would adopt practices found to be successful elsewhere that supported their goals for subsidizing coverage (in terms of both the people receiving subsidies and the types of coverage subsidized), regulating coverage, and so on.”
The bill’s chances of passing are exceedingly slim, with three Republican senators openly opposing the bill in recent days. Sen. John McCain, R-Ariz., came out against the bill last week, and Sen. Rand Paul, R-Ky., has been a vocal opponent of the legislation since its release earlier this month.
Sen. Susan Collins, R-Maine, came out against the bill after the CBO released its report Monday, making her the decisive third Republican opponent that would kill the bill.
“The CBO’s analysis on the earlier version of the bill, incomplete though it is due to time constraints, confirms that this bill would have a substantially negative impact on the number of people covered by insurance,” Collins said in a statement.