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May 24, 5:04 AM EDT

Budget office to gauge health bill effect on coverage, cost


AP Photo
AP Photo/Andrew Harnik

WASHINGTON (AP) -- Congressional Republicans are about to learn more about whether their drive to dismantle President Barack Obama's health care law has been worth the political pain they've been experiencing.

The Congressional Budget Office planned to release its estimate Wednesday of what impact the GOP's House-passed health care overhaul would have on coverage and premiums.

The report could give talking points to House Republicans for their bill, or to Democrats who voted unanimously against it. For GOP senators holding private meetings to sketch out their own legislation, its figures could serve as a starting point as they consider changing the House's Medicaid cuts, tax credits and other policies.

"We'll use that sort of as a backdrop against which to plan some of our Senate options," said No. 3 Senate GOP leader John Thune of South Dakota.

The nonpartisan budget office, lawmakers' official fiscal analyst, released two reports on earlier versions of the House bill in March. Both concluded that the legislation would increase the number of uninsured Americans by 24 million over a decade, a mammoth number that contributed to GOP defections that thwarted House passage until they narrowly approved revised legislation this month.

The budget office also said the legislation would increase premiums by an average 15 percent to 20 percent over the next two years, but push premiums 10 percent lower than they'd otherwise be by 2026. Many Republicans say their chief goal is to reduce premiums.

In late April, moderate and conservative leaders helped craft new language that eked out enough votes for its 217-213 approval on May 4.

Those provisions included waivers states could get for insurers to raise premiums on some people with pre-existing conditions, and to ignore health benefits that must be covered under Obama's law. States could also gain permission for insurers to charge older customers far higher premiums.

Hoping to make Republicans vulnerable on the issue, Democrats have attacked those changes as victimizing people with serious and costly-to-treat medical problems.

The House bill would reduce taxes by around $1 trillion over the coming decade, the budget office said, largely on higher income people and health care industry firms. It would replace Obama's tax subsidies for health insurance consumers, based largely on income and premiums, with GOP tax credits geared more to people's ages.

Most of those losing coverage would be beneficiaries of Medicaid, the health care program for poor and disabled people, though people buying individual policies or getting coverage at work would also become uninsured. The last budget office report said the House bill would cut Medicaid by $839 billion over 10 years.

Erasing former President Barack Obama's health care law was a top promise of Donald Trump during his presidential campaign, and by congressional GOP candidates since its 2010 enactment.

But writing legislation that can pass with only Republican votes has proven agonizing. House Speaker Paul Ryan, R-Wis., canceled a March vote after opposition from party conservatives and moderates would have sealed its defeat, and the two wings of the GOP spent weeks blaming each other for the bill's demise.

Meanwhile, the Trump administration released a report Tuesday that found a 105 percent increase in average premiums for individually purchased coverage from 2013, just before Obama's statute took effect, to this year.

The report from Health and Human Services looked at premiums in the 39 states served by HealthCare.gov, the online exchange for buying coverage. It found the average monthly premium increased from $224 in 2013 to $476 in 2017.

However, the comparison may not be exactly apples-to-apples. Prior to 2013, insurers were allowed to turn away people with health problems, and there was no federal requirement for a standard benefits package. Those two "Obamacare" changes made coverage more robust, but also increased the cost.

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