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CBO score of Senate bill looks similar to House bill in having 22 million more people uninsured

Cruz amendment to allow stripped down plans for healthy consumers not included in CBO score.

Susan Morse, Executive Editor

The Congressional Budget Office has released a second score in as many days on what coverage would like under the Senate bill that Senate Majority Leader Mitch McConnell pulled earlier this week.

The CBO scored the Better Care Reconciliation Act of 2017, minus an amendment by Senator Ted Cruz to allow insurers to offer stripped down plans to healthy consumers.

The Congressional Budget Office didn't have a chance to score that version of the bill and instead analyzed the Senate bill based on a more-recent draft that omits the amendment, according to Business Insider.

The Senate bill score looks similar to that of the House healthcare bill from June, in that 22 million more people would be uninsured in 2026 compared to that number under the current Affordable Care Act.

In 2018, 15 million more people would be uninsured under the Senate bill than under current law. This would reach 19 million in 2020 and 22 million in 2026, the CBO said.

In 2026, an estimated 82 percent of all Americans under the age of 65 would be insured, compared with 90 percent today.

Premiums in the individual market would be about 20 percent higher than under current law, mainly because of the removal of the penalty for not having coverage, the CBO said. In 2019, premiums would be about 10 percent higher and by 2020 about 30 percent lower than under current law. By 2026, average premiums would be about 25 percent lower than under current law.

Premiums would vary based on area of the country and age. A 64-year old could be charged five times as much as a 21-year-old, compared as three times as much under current law, the CBO said.

Deductibles for a single policyholder for benchmark plan, the equivalent of a silver plan, would be about $13,000 by 2026, the CBO said. This would be for medical and drug expenses combined.

"Because a deductible of $13,000 would be a large share of their income, many people with low income would not purchase any plan even if it had very low premiums--on net, after accounting for premium tax credits," CBO Director Keith Hall said. "Under this legislation, in 2026, that deductible would exceed the annual income of $11,400 for someone with income at 75 percent of the FPL (federal poverty level)."

Medicaid spending would be reduced by 26 percent, with three-quarters due to ending Medicaid expansion now in place in 31 states and the District of Columbia.

Medicaid spending would be reduced by 87 percent from $134 billion to $17 billion from the expansion program. All other Medicaid spending would be reduced by 9 percent, from $490 billion to $447 billion, the CBO said.

The Senate bill would reduce the federal deficit by $420 billion through 2026. This is the result of a $903 billion decrease in direct spending offset by $483 billion in revenues.

The CBO compared this score to one done on June 26 for the House version of the healthcare bill. Compared to the House bill, the Senate bill would have larger cost savings over the next ten years, and greater deficit reductions because it would retain taxes that were done away in the House bill.

The bill would lower the federal deficit by reducing spending for Medicaid and subsidies for nongroup health insurance. These would be offset by effects of provisions of a reduction in taxes, the repeal of penalties in the individual and employer mandate that was in the ACA, and spending to reduce premiums.

On July 19, the CBO and Joint Committee for Taxation tallied the effect of a repeal of the Affordable Care Act. The CBO report gave blistering numbers of 32 million more Americans uninsured over 10 years and a doubling of premium costs during the same period.

Twitter: @SusanJMorse