House Speaker Paul Ryan asserted on June 27 that 22 million people, whom the Congressional Budget Office (CBO) estimates would lose their health care under the GOP Senate plan by 2026, will choose not to buy health insurance because they won't be required to (video below).
Ryan announced his theory during a "Fox & Friends" interview:
What they are basically saying at the Congressional Budget Office, if you’re not going to force people to buy Obamacare, if you’re not going to force people to buy something they don’t want, then they won’t buy it. So, it’s not that people are getting pushed off a plan, it’s that people will choose not to buy something that they don’t like or want.
And that’s the difference here. By repealing the individual and employer mandate, which mandates people buy this health insurance that they can’t afford, that they don’t like, if you don’t mandate that they’re going to do this then that many people won’t do it.
It also says that if states don't expand Medicaid in the future, then fewer people will go on Medicaid in those states that don't expand in the future.
However, the CBO report does not say that people will voluntarily choose not to buy health insurance simply because they don't like being required to do so.
Obamacare didn't require people to buy insurance that they could not afford. It has been the law for eight years that people can apply for exemptions from the health insurance requirement based on "certain hardships, some life events, health coverage or financial status, and membership in some groups," according to HealthCare.gov (Obamacare website).
The GOP Senate bill cuts Medicaid expansion for low-income people, which will likely result in millions being uninsured unwillingly.
The Los Angeles Times reports that Medicaid eligibility would be rolled back to where it was before Obamacare under the GOP plan, which is how the cuts will happen.
The CBO noted in its report that, under the GOP Senate bill, the subsidies that people use to buy insurance with would be "substantially smaller than under current law," reports The New York Times.
The CBO also said that premiums and deductibles would be such a financial burden that "few low-income people would purchase any plan."
According to the CBO report, older people would have to pay more for their premiums than what they currently pay under Obamacare.
Additionally, the CBO noted the GOP Senate bill would allow states to apply for waivers, which would allow those states to get rid of Obamacare's "essential benefits" such as mental health care, maternity care, rehab and prescription drugs.
When the House version of the GOP health care bill was passed, the CBO estimated 23 million people would lose their health care coverage, and that pre-existing conditions would return to states that applied for waivers (also in the Senate bill).