Andrew Prokop is a senior politics correspondent at Vox, covering the White House, elections, and political scandals and investigations. He’s worked at Vox since the site’s launch in 2014, and before that, he worked as a research assistant at the New Yorker’s Washington, DC, bureau.
The Congressional Budget Office projects that if signed into law, Senate Republicans’ proposed “skinny” health care bill would lead to 16 million fewer people having insurance by the year 2026, according to a newly released score.
The eight-page bill, the Health Care Freedom Act of 2017, was released late Thursday night, just hours before a planned final Senate vote on it. You can read Sarah Kliff’s full explainer on it here — among other provisions, it would eliminate Obamacare’s individual mandate and eliminate the employer mandate through 2024.
Though the Senate bill leaves Obamacare’s subsidies and its Medicaid expansion in place (and doesn’t include the deep Medicaid cuts that were in the House bill), the CBO has long scored the mandates as very powerful, and projects that their elimination would result in far fewer Americans having insurance because they would be able to forgo it without risking a penalty or fearing that they’re violating the law.
If this bill were to be signed into law, the CBO projects that the percentage of Americans with insurance will drop from 90 percent in 2017 to 85 percent in 2026.
Some argue that those newly uninsured people are in fact being freed from being compelled to purchase insurance under a mandate. But the risk is that predominantly healthy people will withdraw from the individual marketplaces and the remaining participants will be sicker — causing premiums to rise for everyone else. This is the scenario often called a “death spiral.”
The CBO scored the bill’s budgetary implications too, finding that overall, it would reduce the deficit by $178 billion over the next 10 years. They project that spending on coverage provisions would drop by about $275 billion in that timespan, while revenues would also drop by about $100 billion.
Now, Senate Republicans are claiming that they don’t actually want this bill to come become law, and are merely trying to pass it as a vehicle to kick-start a conference committee process with the House. But if they do pass this skinny bill, it is entirely possible that the House will also pass it, without making any changes to it, and send it to President Trump’s desk for his signature.
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