But, if the ACA, in its present form, was allowed to keep on keepin’ on with no changes, CBO estimated 26 million Americans would not have health insurance coverage in 2026. Weren’t we promised far fewer than that would be without health insurance?
The ACA has performed pretty much as effectively as expected, after a rough start as people held out for repeal, exchange websites didn't function, and implementation was delayed. the CBO thought the uninsured 2016 rate would be 11%, it was 10%. Obama set a bar far lower than that, many say intentionally undercutting the numbers to ensure "success." But the official government target was dang near spot on.
The
CBO estimates that under the Trump plan there will be 26 million
additional Americans without health insurance in 10 years . That is double the number we expect under the current law and it is predicted to be more uninsured people than the United States has ever seen (since we kept track of such a thing).
Exactly the opposite of Trump's promise to make sure everyone has coverage. We are currently
near a record low for number of people without health insurance (11.3%, up from 10.9% when Trump took office). It was nearly 18% when the ACA took affect (
nearly 50 million people.)
Under previous trends we expect the rate to drop and the total number of people to remain fairly flat. Under the new plan, we expect to see more people without insurance going forward than we ever have before.
And of course that is ignoring that of the approximately 26,000,000 adults who are not insured,
5.2 Million would be insured if eligible states expanded Medicaid. That would reduce the rate to ~7-8% of the population without health insurance and further reduce the number moving forward. The current rate is about exactly where the
CBO thought ObamaCare would get us, if additional states expanded Medicaid the program would have greatly exceeded expectations.
In short - ACA was as effective in reducing the uninsured rate as expected. The new plan ends up with more uninsured than ever before (and frankly about where we would have been without the ACA). All to supposedly "save money."
But the new healthcare law saves us $119 Billion over ten years. When coupled with the other Trump provisions we would likely see a deficit increase over current projections of
$4,000,000,000,000.00 in ten years ($4 Trillion, unless the cuts and increased military spending cause the economy to double or triple its growth rate [which no economist will say] - then it is "only" a $2 Trillion deficit increase over current projections). Pretending this is something to save the government money doesn't fly.
------
I'm not pointing this out for some "everyone deserves health insurance yay peace and love" reason. But we have been paying double the money for worse results than most industrialized countries for decades. At the same time the number of people cut off from all but emergency healthcare has ballooned, leading to even more inefficiencies (so many ER docs have to waste time playing primary care doc or treating conditions that should have been headed off months earlier, then we whine about ER wait times and ER docs not spending enough time with us. Let alone the general inefficiency of treating stage 4 crisis over prevention or catching it early). Not only does this bankrupt families, it ends up costing ME additional money because I pay for healthcare, which is jacked up to help pay for people's healthcare who bankrupted out of their bills. Of course it is worse when you factor in those who would otherwise be willing or able to work, but can't because of a health issue so are now on disability.
And that's not mentioning the pressure on private sector (and public) employers trying to compete with overseas companies who have a built in efficiency in healthcare. 18% of all GDP in this country is spent on healthcare. That's nearly double the GDP expenditure than the average OECD country and nearly 6 full points above the #2 nation by GDP (Denmark). That means US companies have to pay a huge amount of employee healthcare and/or pay more to employees. On average Americans (and/or the government or their employer healthcare) is paying $5,000 each more, per year, for healthcare than the average person in an advanced economy.
The system has grown inefficient and less than optimally effective. It has been straying further and further away from "fixing" itself. I'm not arguing the ACA is a solution, but something has to change. Going back to the way it was as the system grew dysfunctional isn't likely to fix it either, it leaves twice the number of people without insurance, and doesn't really save money.
