Partial ACA Repeal Could Leave Up to 32 Million Uninsured, Report Estimates

Amidst recent efforts to dismantle the Affordable Care Act (ACA), a newly-released report has suggested that repealing several provisions of the health reform law could potentially raise premiums and leave millions of Americans without health insurance coverage.

The report, published by the nonpartisan Congressional Budget Office (CBO), examined the possible effects of the vetoed Restoring Americans’ Healthcare Freedom Reconciliation Act of 2015 (H.R. 3762). Upon enactment, H.R. 3762 would have eliminated penalties associated with the individual and employer mandates of the ACA. About 2 years after its enactment, the bill also would have eliminated the expansion of Medicaid eligibility and the marketplace subsidies afforded by the ACA.

Based on its analysis, the CBO estimated that about 18 million individuals would lose insurance within the first new plan year of the bill’s enactment. This number would increase to 27 million after the ACA’s expansion of Medicaid eligibility and marketplace subsidies are eliminated, and could ultimately reach 32 million by 2026.

The CBO also predicted that nongroup market premiums could increase by 20 to 25% in the first new plan year following the enactment of H.R. 3762. These premiums would then see an increase of about 50% in the year after Medicaid eligibility expansions and marketplace subsidies are eliminated; by 2026, they could nearly double.

The CBO report indicated that the loss of marketplace subsidies would reduce enrollment in health plans, leading insurers to withdraw from the individual insurance market and public marketplaces. As a result, nearly half of the nation’s population would live in areas where no insurers participate in the nongroup market within the first year after the subsidies are eliminated, and about 75% of the population would live in these areas by 2026.

However, the CBO acknowledged that the effects of legislation similar to H.R. 3762 would depend largely on the specific provisions of such a bill, as well as on a possible ACA replacement.

“Today’s report shows only part of the equation — a repeal of Obamacare without any transitional policies or reforms to address costs and empower patients,” Senate Finance Committee Chair and President Pro Tempore Orrin Hatch (R-UT) told the New York Times. “Republicans support repealing Obamacare and implementing step-by-step reforms so that Americans have access to affordable health care.”

Although congressional Republicans have yet to put forth a replacement bill, organizations ranging from the American Medical Association to the United States Conference of Catholic Bishops have cautioned lawmakers against repealing the ACA without definite plans to replace it. Additionally, the Department of Health and Human Services has released a report highlighting the prescription drug benefits of the ACA, while the National Community Pharmacists Association has penned a letter to key representatives identifying several of the law’s essential provisions.