CBO Predicts Obamacare Repeal Could Leave Millions Without Insurance

A Congressional Budget Office analysis requested by Democrats says a repeal of Obamacare could leave millions uninsured. But Republicans insist they will come up with a replacement law to provide insurance.

KELLY MCEVERS, HOST:

Republican lawmakers intent on repealing Obamacare are getting a warning from congressional forecasters. The nonpartisan Congressional Budget Office says stripping away parts of the law could leave 18 million people without health insurance in the first year after a repeal and many more people in the years that follow. The office says it would also cause premiums in the individual insurance market to spike.

Republicans are dismissing the forecast. They say it doesn't account for their plans to replace Obamacare. Democrats hope to capitalize on the warning at a time when many Americans are worried about the future of the health-care system. To talk about this, we have NPR's Scott Horsley now. Hi, there.

SCOTT HORSLEY, BYLINE: Hi, Kelly.

MCEVERS: So the CBO is painting a pretty bleak picture here. What are the forecasters afraid is going to happen?

HORSLEY: Well they're afraid that, if on the one hand, you take away the carrots in the Affordable Care Act, the government subsidies that help lower-income people buy insurance, and you take away the stick - that is the tax penalty for people who don't buy coverage - then you're going to have tens of millions of people dropping out of the individual insurance market, some by choice and some because they simply can't afford insurance.

And when you have that kind of exodus, the people who are left are those who need insurance the most, the older, sicker and more expensive patients. So the cost of premiums goes up. And the number of insurance companies offering coverage goes down. We've already seen this happening to some extent with the Affordable Care Act as it is because the carrots aren't juicy enough, the sticks not big enough. If you take those away altogether, then the problem could get that much worse.

MCEVERS: Republicans, as I mentioned, are saying this forecast is meaningless and incomplete. Does it leave some things out?

HORSLEY: It does. What the Democrats asked the CBO to do was go and look at what the Republicans passed last year, which was kind of a dry run for repeal. What the bill did was take away insurance subsidies, took away the requirement that individuals buy insurance. It didn't take away the requirement that insurance companies cover everyone regardless of pre-existing medical conditions because Senate Democrats could filibuster that. And the result of that partial repeal, according to the CBO, would be a very unstable insurance market - individual insurance market - with soaring premiums and insurance companies bailing out.

MCEVERS: Republicans say the CBO did not include their proposals to replace Obamacare. Why not?

HORSLEY: Well, the GOP has yet to really coalesce around any single replacement plan. You've got some Republicans in Congress who've talked about finalizing their plan at a retreat later this month. You've got President-elect Trump saying he'll roll out his plan just as soon as his health secretary is confirmed. What Democrats, like Senate Minority Leader Chuck Schumer, are trying to do with this report is say, look, here's what repeal does. How does the GOP replacement plan try to overcome that?

(SOUNDBITE OF ARCHIVED RECORDING)

CHUCK SCHUMER: Now that repeal is real and not just a political exercise, the tide is turning. The American people are becoming roused by the prospect of dismantling health reform and leaving chaos in its wake.

MCEVERS: Quickly, Scott, are the American people becoming roused?

HORSLEY: Well, there is a new poll out today from NBC and The Wall Street Journal that finds, for the first time, more people think Obamacare is a good idea than a bad idea. It's still not real popular, and there are still deep divisions on a partisan basis. But fully half those polled say they have little confidence that the GOP replacement plan will be any better. So that's a political caution for the Republicans along with the health-care caution from the CBO.

MCEVERS: NPR's Scott Horsley, thank you.

HORSLEY: You bet.

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