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Healthy Questions?

Monday, the CBO (Congressional Budget Office) report on the Republican health care bill came out, and it was even harsher than I expected. The CBO says that the new bill will increase the number of uninsured by 86%. Donald Trump promised that no Americans would lose coverage.

In fact, the Republican bill is so bad, it will make things worse than before Obamacare. In the first year alone, the number of people without health insurance will increase by 14 million. Not only that, but premiums for the people who still have insurance will increase (on average) 15 to 20 percent. The individual market and older people will see the largest increases.

The only “good” news from the CBO is that the new bill will decrease the deficit, but only because it will severely cut Medicaid, reducing enrollment by 14 million unlucky people. Some of that savings will reduce the deficit, but the rest will go into tax cuts for the wealthy. Of course, that savings is a mirage, because as we know these people will still get sick, and will end up in emergency rooms (which are required to treat anyone regardless of ability to pay). So in the end, we will pay for that too in the form of higher hospital charges to make up for the shortfall.

I’m guessing the Republicans knew this report was going to be bad, because they have been falling over each other trying to discredit the CBO. They couldn’t really attack the CBO as being partisan, because Republicans appointed its director in 2015.

Instead, Republicans attacked the CBO’s accuracy, complaining that the CBO projected in 2010 that the ACA would reduce the ranks of the uninsured by 30 million, but so far only 22 million have gained insurance under the bill. What the GOP conveniently forget to mention is that two years after the bill was passed, 21 Republican-led states refused to expand Medicaid. That deliberate sabotage was the major cause of the shortfall.

Predicting the future is difficult, but even so, experts have studied the CBO and found their projections to be sound. Between 1983 and 2014, the CBO’s two-year revenue forecasts were only off by 1.1%, which is pretty darn accurate. Five-year forecasts were only off by 5.3%, which is amazing.

But arguing over the absolute accuracy of the CBO is arguing over the wrong question. The more important question is whether the CBO projection was more accurate than the predictions of gloom and doom spewed out by the Republicans. Remember all the warnings about “death panels”, and how Obamacare would destroy our economy? Indeed, Donald Trump is now bragging about the economy that Obamacare was supposed to have destroyed.

© Jen Sorensen

Also published on Medium.



  1. PatriotSGT wrote:

    Yes, they need to take some time and get this right. The Rupublicans have only had 7 years to come up with a plan. Apparently, Trump believed them too that they had a plan ready. Maybe he’ll fire them as well.
    On the CBO scoring you did not mention that many of the losses to the insured ranks are because people ( likely younger) will choose not to buy insurance. Also the CBO report said that premiums will continue to increase as they have for the last several years, and in 3-4 years start to come down while reducing the deficit significantly.
    One of the big problems with the ACA is run away premiums, and unaffordable deductibles making the insurance useless unless you have a major illness. This doesn’t effect the poor because they don’t pay anyway, but does significantly impact the middle class.
    I hope that both parties see the need to contribute to a better plan, but in this partisan environment both will likely put politics ahead of the welfare of the nation.

    Tuesday, March 14, 2017 at 9:52 am | Permalink
  2. Jonah wrote:

    This CBO report clearly exposes one of Trumps biggest lie which was that he had a plan to incease or maintain the number of insured AND reduce premiums. Voters fell for it hook line and sinker. Conservatives at least in the house should approve this bill since it reportedly reduces the deficit. The number of covered lives goes down but i’m sure the republican mantra is that you cant make an omelette without breaking an egg. And surely given that Trump is a “successful” businessman I’m shocked that he couldnt get a better deal. At the very least Trump and the republicans should do what they promised. Repeal obamacare. They promised to have a special session on day 1 and repeal the bill so I’m wondering why there is a hold up.They have the votes and the means the do it. Surely a successfull and brilliant negotiator like Trump can convince the republicans to grow a pair and do it.

    Tuesday, March 14, 2017 at 10:49 am | Permalink
  3. btn wrote:

    A common problem with Bush’s Prescription Drug Bill, ObamaCare, and TrumpDontCare is that NONE of them address the rapidly rising COST of Healthcare, instead just subsidizing the PRICE of Healthcare.

    I really hope this bill passes. If it does, then people will realize that Donald Trump and the Republican party do not represent the working class.

    If the bill fails to pass, Republicans will still lose seats in 2018, but their voters will just think they voted for the *wrong* Republicans (broke promise to repeal ObamaCare) instead of realizing that voting Republican was the problem. Donald Trump will blame Congress for not repealing and fixing health care and his supporters will still trust him.

    Tuesday, March 14, 2017 at 12:38 pm | Permalink
  4. redjon wrote:

    Republicans promised to turn things around when they finally gained power, and they’re working very hard to do so.

    In spite of wars and continued civil strife, this country has made great strides in the last 50 years… GREAT strides.

    The current GOP is positioned nicely to undo that progress, and a majority of the people don’t care enough about it to even bother to vote.

    Tuesday, March 14, 2017 at 1:13 pm | Permalink
  5. Iron Knee wrote:

    PSgt, those of us who have had to pay our own premiums on the individual market know that premiums have increased less under Obamacare than they did previously. Yes, there are a few states where premiums have shot up (mainly Arizona), but on average they have not. And most of the premium increases were caused by the fact that the ACA requires insurers to cover people with pre-existing conditions, and also because the law requires insurance to cover preventative care and other things that were often not covered by cheap insurance, but whose ommision are not cost effective in the long run.

    Also, the majority of people who will lose their insurance are people who are currently on Medicaid. Not people who chose not to have insurance. Sure there will be some people who will chose to not have health insurance, but those people will cost the rest of us when they end up in hospital emergency rooms. In the same way that my car insurance includes a payment for “uninsured motorist coverage”.

    Tuesday, March 14, 2017 at 2:14 pm | Permalink
  6. Jonah wrote:

    I’ll add that Trumps efforts to sabotage Obamacare are shameful.

    People lives are at stake and these are american lives and this nincompoop is playing politics with it. Not enough attention is being given by the media to this topic. The president of the united states is intentionally sabotaging the current healthcare system so that he can reduce taxes on his billionaire buddies. Why is this not criminal?

    Wednesday, March 15, 2017 at 7:49 am | Permalink
  7. Jonah wrote:

    The republicans had more than enough time to come up with a bill and now are arguing over who takes the blame

    Wednesday, March 15, 2017 at 8:04 am | Permalink
  8. Ralph wrote:

    There’s hardly anything more to say about the failures our healthcare system that hasn’t already been covered in this or previous posts. This latest episode involving the AHCA removes all doubt about what we should already know.

    That being, it should be crystal clear and painfully obvious to all by now, if not through all the years of the Obama Admin, that Republicans have no interest whatsoever in proposing or working towards a viable alternative to the ACA that provides for the general health and well-being of the population as a whole. Don’t wait for it, get used to it, never gonna happen with this bunch. Any program that doesn’t comport with the free and unencumbered capital markets motivated by profit is not in their playbook and not worth their time, beyond appearances anyway.

    I mean, 50+ failed attempts to repeal the ACA over 6-7 years without putting a single alternative bill up for debate or vote tells us at least that much.

    Instead, after doing everything possible to sabotage it, as IK described, and now being the majority party in Congress, they rushed to cobble together a bill they assumed would breeze through. Slap an “American” in the title for good measure (that always makes it sound better, just like “Freedom Caucus”, right?), try to sell it as “new and improved” when it really amounts to nothing more than reduced coverage and increased costs for those who need health insurance the most, while subversively granting generous tax cuts for their sugar daddy donors. Then shoot the messenger (CBO) who predictably reveals it to be the dumpster fire it really is.

    The “face palm” moment for me was learning that a significant portion of this slim bill (8-10 pages, if not mistaken) is dedicated to ensuring that state lottery winners be denied subsidies otherwise grudgingly granted to their income brackets. Well, we can’t be letting a few little people think they can get away with a lucky undeserved windfall now, can we? We have hedge fund managers for that.

    My only question is, how much longer can even the most gullible fall for this most obscene level of duplicity?

    But my favorite non-sequitur of the week was Trump admitting to his astonishment that “who knew healthcare could be so complicated?” (uh, literally everyone), while Spicer did a laughable show-and-tell with copies of the ACA and AHCA by his side as physical evidence that the AHCA is obviously better because it’s virtually an order of magnitude smaller and not “big government”. Who knew smaller was better for the Oh So Complicated?

    I’ve said it a million times and I’ll say it again. Until our healthcare system is freed from its excessive and opaque profit motive, and becomes more an outcome-based than fee-for-service model, this problem will never be solved to the satisfaction of most.

    That’s my sick story and I’m stickin’ with it!

    Thursday, March 16, 2017 at 8:57 am | Permalink