Despite the modifications to Trumpcare, the Obamacare replacement bill is still a massive dumpster fire that would further exacerbate the problems plaguing the health care system. Conservatives in Congress are rightly skeptical about the bill, so the president is now threatening them with primary challengers in 2018.
Here are five statistics that reveal the mess that is Trumpcare.
1. Around five million people would lose their insurance under Trumpcare. The CBO has estimated that 24 million people will lose their insurance, but the CBO has a poor track record and there are issues with the CBO's analysis of Trumpcare. Health care policy wonk Avik Roy explains in Forbes that there are three fundamental problems with the CBO's analysis: they overestimate the amount of people enrolling in the Obamacare exchanges, they count people who choose not to purchase insurance under the individual mandate's repeal as uninsured and they include states choosing not to expand Medicaid as part of that total.
"You add all that up – 7 million off on future exchange enrollment, around 9 million off on the individual mandate’s power, and 3 million off on future Medicaid expansions – the CBO's estimate of the impact of the AHCA [American Health Care Act] on coverage is off by around 19 million, and that the real impact of the AHCA on coverage is negative 5 million," writes Roy, adding that his five million estimate could end up being smaller or larger.
However, Roy notes that even though the CBO's analysis is flawed, Trumpcare "would still cover fewer people than Obamacare." That is a major problem.
2. Trumpcare would raise premiums by an added average of 15 to 20 percent by 2020, particularly harming older Americans. The 15 to 20 percent figure also comes from the CBO's analysis, so there's a good chance that it's off. But it's worth noting that the CBO's report makes it clear that Obamacare's regulations left in place by Trumpcare are what's driving up premiums. Conservative Review's Daniel Horowitz points out that premiums will start to decrease after 2020 because Obamacare's actuarial value regulation will be repealed by then. But the health care sector will be plunged into the death spiral before then, so that point will never be reached.
Additionally, that 15 to 20 percent increase is in addition to slated increases under Obamacare, further proving that Trumpcare will worsen the health care sector.
The higher premiums predicted by the CBO is in line with Roy's findings that the "near-elderly" will be especially harmed by Trumpcare. According to Roy, "A 50-year-old childless adult making 200 percent of the Federal Poverty Level" would face higher net annual increases with premiums of $4,078 under Trumpcare as opposed to $1,520 under Obamacare. A 60-year-old childless adult at that same level would see increases of $9,080 in their premiums under Trumpcare instead of $1,520 under Obamacare.
Clearly, Trumpcare is going to cause premiums to be even worse than they were under Obamacare.
3. A version of Trumpcare was attempted in U.S. territories; all insurers fled their health care market. Horowitz explains:
To begin with, the U.S. territories, such as Guam, American Samoa, and the Northern Mariana Islands, unlike the states, were exempt from the individual mandate because of the way Obamacare was drafted. However, they were still subjected to the insurance coverage regulations – the very combination that would apply to all states if the House GOP bill were to pass. The result? The market was so insolvent all individual insurers left territories such as the Northern Mariana Islands within just two years of implementation. In 2014, the territories petitioned for a waiver from the insurance coverage regulations and were granted a waiver from many of the provisions by Obama’s HHS.
The same result can be expected for the rest of the country if Trumpcare passes, although waivers won't be enough at that point; Horowitz argues that by then the only options "will be either single payer or a massive TARP-style bailout of insurance companies."
4. Trumpcare would only reduce the deficit by $337 billion in a span of ten years, but even that number is generous. This is according to the Associated Press; it appears that a big reason for that number is an $880 billion cut in Medicaid in that same timeframe. The problem is that Medicaid will still be allowed to expand until 2020; by then the death spiral will have already occurred so it is more than likely that a future Congress will undo those Medicaid cuts.
5. On average, only 30 percent of voters support Trumpcare while 47 percent are against it.
The GOP bill is *really* unpopular. And strong opposition greatly exceeds strong support. A good formula for losing lots of House seats. pic.twitter.com/URE34OiHjf— Nate Silver (@NateSilver538) March 21, 2017
The ramifications of Trumpcare are going to be detrimental, as Daily Wire editor-in-chief Ben Shapiro writes:
Here’s the truth: the easiest play for Trump would have been a clean repeal of Obamacare, and then a piecemeal plan for fixes. That’s what Republicans pledged for years. But his own Health and Human Services Secretary has now ruled such a plan out. That means for Trump, it’s Trumpcare or bust.
And if it busts, the results will be disastrous for his presidency. Trump will likely blame Ryan and advisor Reince Priebus for the flameout, and turn against them in favor of more populist nationalist legislation, attempting to ally with Democrats in the process. He’ll move toward primarying Republicans he doesn’t like. Legislation like tax reform could founder on the shoals of such rifts.
This legislative rock-and-hard-place was created by Trump and Ryan. They own it. Trump hopes that with his typical forcefulness, he’ll be able to cram through anything. But that’s not how the process works. And right now, the future of a Trump-Republican legislative utopia looks dim.