Analysis: GOP Bill Would Kick 32 Million Off Insurance

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An analysis conducted by a progressive-leaning group estimates that GOP lawmakers' latest proposal to repeal and replace the Affordable Care Act could result in 32 million Americans losing their health insurance after 2026.

Senate Republicans are expected to vote on the legislation before the Congressional Budget Office can provide an estimate on how the policy would impact insurance markets and patient coverage.

On Sept. 18, the conservative effort to repeal the ACA, also known as Obamacare, gained a second wind when Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana introduced a bill that would transform the U.S. health care system into federal block grants for states. The GOP-majority Senate has until Sept. 30 to pass the legislation through budget reconciliation to avoid a filibuster from their Democratic colleagues, only 12 days after it was proposed, CNN reports.

The same day the bill, known as Graham-Cassidy, was introduced, the CBO announced it would not have enough time to estimate how the legislation would impact insurance premiums and access to coverage before the end of the legislative session.

"CBO will provide as much qualitative information as possible about the effects of the legislation," two CBO officials wrote in a Sept. 18 blog post. "However, CBO will not be able to provide point estimates of the effects on the deficit, health insurance coverage, or premiums for at least several weeks."

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On Sept. 20, the progressive-leaning Commonwealth Fund provided an analysis of Graham-Cassidy, basing its predictions on CBO scores of previous health care legislation. The analysis estimated that if the proposal became law, then up to 18 million more Americans would be uninsured by 2019 than if the ACA was kept intact, Business Insider reports.

Graham-Cassidy would eliminate the ACA's individual mandate and place a federal spending cap on Medicaid. The legislation would take federal subsidies and Medicaid funding under the ACA and turn them into lump sum payments to states, known as block grants. Those blocks grants would expire by 2026, according to ABC News.

The Commonwealth Fund estimated that up to 32 million Americans would be without health insurance by 2026, when the block grants would expire. The analysis also estimated that premiums would increase by up to 20 percent by 2019, according to Business Insider.

"The majority of that increase would come from the repeal of the mandate penalties: insurers would expect that those who remained in the pool would be the least healthy," wrote Sara Collins of the Commonwealth Fund.

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The analysis also noted that while Graham-Cassidy would protect Americans with pre-existing conditions from being denied coverage, it could potentially make their insurance unaffordable.

"It would allow states to apply for waivers that would let insurers charge people with health problems higher premiums, and change other ACA consumer protections such as bans on lifetime benefit limits and comprehensive coverage requirements," Collins concluded.

U.S. physician organizations have universally condemned Graham-Cassidy. So far, the American Medical Association, the American Psychiatric Association, the American Public Health Association, the National Institute for Reproductive Health and the Federation of American Hospitals have publicly opposed the bill, The Atlantic reports.

GOP lawmakers have signaled that they are prepared to support Graham-Cassidy before the public is made fully aware of its impact on the U.S. health care system. On Sept. 20, Republican Sen. Chuck Grassley of Iowa told reporters that his colleagues were eager to fulfill the GOP's campaign promise of repealing the ACA.

"I could maybe give you 10 reasons why this bill shouldn't be considered," Grassley said, according to CNN. "But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That's pretty much as much of a reason as the substance of the bill."

Sources: ABC News, The AtlanticBusiness Insider, CNN (2), Congressional Budget Office / Featured Image: Pixabay / Embedded Images: Michelle Gonzalez/Chief National Guard Bureau/Flickr, George Ruiz/Flickr

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