On Tuesday, CBO released, How Repealing Portions of the Affordable Care Act Would Affect Health Insurance Coverage and Premiums. A report that suggested a dramatic impact on people if the law is repealed without a replacement.

On Friday, as one of his first acts, President Trump signed a broad executive order directing all federal agencies to “ease the burdens” on individuals, states, and the health industry.  It is unclear what such a broad order can or will due short of congressional action but the executive always has the power of not enforcing laws.

The CBO report, conducted by the nonpartisan office was a response to a request by Senate Minority Leader Senator Charles Schumer (D-NY), Ranking HELP Committee member senator Patty Murray (D-WA) and Ranking Finance Committee Member Senator Ron Wyden (D-OR).  CBO was asked what would happen if the ACA were repealed and not replaced and CBO concluded:

  • The number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill. Later, after the elimination of the ACA’s expansion of Medicaid eligibility and of subsidies for insurance purchased through the ACA marketplaces, that number would increase to 27 million, and then to 32 million in 2026.
  • Premiums in the nongroup market (for individual policies purchased through the marketplaces or directly from insurers) would increase by 20 percent to 25 percent—relative to projections under current law—in the first new plan year following enactment. The increase would reach about 50 percent in the year following the elimination of the Medicaid expansion and the marketplace subsidies, and premiums would about double by 2026.

The CBO numbers are an update of information that was provided in the last Congress based on legislation Congress had adopted to repeal the ACA.  Because that legislation was passed used a reconciliation bill (President Obama vetoed the measure after Congress adopted it) it left out repeal of certain insurance industry requirements because that repeal was not allowed under reconciliation rules.  A new reconciliation might try and address that.  Republicans in Congress criticized the analysis saying that they would have a replacement when they repeal the ACA.