We’ve got skinny Trumpcare or Zombie Trumpcare 5.0—or the John McCain Surrenders the Last Shreds of His Integrity bill—finally on the floor and the CBO worked fast to figure out what it’s going to do.
What it’s going to do is kick 16 million people out of their health insurance in the next year. An election year. Because the bill doesn’t include Medicaid, by some miracle, the loss of insurance is somewhat curtailed compared to other bills the Republicans have been struggling with. Besides that, it’s going to increase premiums in the non-group market “by roughly 20 percent relative to current law in all years between 2018 and 2026.” It’s also going to mean a death spiral kicks in, because as fewer healthy people sign up, the higher premiums go and more insurers leave the markets.
That’s as it stands now. The House may or may not decide to go to conference with the Senate to make some changes, or it might just pass this—whatever they think House Speaker Paul Ryan promised about not just passing the damn thing. It’s hard to imagine that they’re going to let this opportunity to destroy Medicaid pass them by. Maybe they’ll just have to accept the indirect cuts it makes to Medicaid.
The Congressional Budget Office’s score of how Medicaid would be impacted by a version of “skinny repeal” was released yesterday and it estimates a cut of $220 billion over ten years and a Medicaid coverage loss of 7 million people over ten years with 3 million happening in the second year.
That’ll be because of fewer people finding out they qualify for Medicaid when they go to sign up for insurance—since there won’t be an individual mandate to prod them into looking for insurance. Maybe Republicans will be content with that. I’m not going to count on that.