Voluntarily opting out of coverage is not the same as losing health insurance

The Congressional Budget Office (CBO) recently released their score of the American Healthcare Act.

In their analysis, the CBO indicated 23 more Americans would be uninsured if the Senate were to pass the AHCA.

See Vox for peak freakout:

The American Health Care Act — the health care legislation that the House passed at the beginning of May — would lead to 23 million more Americans being uninsured in 10 years, versus what would be expected under Obamacare, according to a new report from the Congressional Budget Office. The House bill would also cut taxes by $662 billion over the next decade, according to a separate analysis released Wednesday by the Joint Committee on Taxation, mostly by repealing Obamacare taxes on the wealthy and health care industries. House leaders were criticized intensely for having their members vote on the bill without a full report on its possible effects on May 4. Three weeks later, the consequences of that vote, if the bill as written were to become law, are finally clear.

Amazingly, the AHCA’s tax cutting, deficit saving benefits are omitted from most headlines. But back to the uninsured numbers. How did the CBO determine some 23 million more Americans would likely find themselves health insuranceless?

By using faulty baselines, of course:

As expected, CBO is using the March 2016 coverage baseline that they have already acknowledged is WILDLY wrong. pic.twitter.com/zjK96jUkaX — Phil Kerpen (@kerpen) May 24, 2017

How wrong is the 2016 coverage baseline CBO used? Off by at least 5 million people *according to CBO themselves*!https://t.co/DlbhIi3FgZ — Phil Kerpen (@kerpen) May 24, 2017

@kerpen Here is the annual error in covered lives of the CBO 2016 and 2017 baseline. Shocking something so out of date can be used. pic.twitter.com/unHd1kXWxQ — Daniel Clifton (@DanCliftonStrat) May 24, 2017

So faulty are the CBO’s projections, the Health and Human Services released a lovely graph charting the inaccuracies of the CBO’s projections on the Obamacare coverage:

Back in March, when the first round of projections was released, Mary blogged:

Senate Minority Leader Chuck Schumer (D-NY) said the analysis proves “that TrumpCare will cause serious harm to millions of American families.” The CBO report disputes Sen. Schumer’s claims on the SECOND PAGE: BCO and JCT [Joint Committee on Taxation] estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law. Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying penalties, and some people would forgo insurance in response to higher premiums. The CBO believes the uninsured number will go up to 24 million by 2026 due to “changes in Medicaid enrollment – because some states would discontinue their expansion of eligibility, some states that would have expanded eligibility in the future would choose not to do so, and per-enrollee spending in the program would be capped.”

It’s worth reiterating that should there be a drastic rise in uninsured Americans, it won’t be because the AHCA destroys their health insurance plans or makes coverage unattainable, it will be because in the absence of the individual mandate, many will simply opt out of health insurance entirely. At least until the market makes it more affordable.

Follow Kemberlee on Twitter @kemberleekaye



