It might be called an improvement, but it's still hardly anything to boast about.
The Centers for Medicare and Medicaid Services' office of the actuary has released a new report which estimates the number of Americans who would lose their health care coverage in the next 10 years under the American Health Care Act at 13 million, "mostly as a result of declines in eligibility for Medicaid, the impact of the repeal of the individual mandate, and the net reduction to the subsidies available for the purchase of individual insurance."
The Congressional Budget Office put that number at 23 million.
Recommended For You
A USA Today report quotes Larry Levitt, executive vice president at the Kaiser Family Foundation, saying, "All these kinds of projections are uncertain and require lots of assumptions, so the range between what the actuary is saying and what CBO estimated is within the realm of what's possible."
One major unknown that contributes to the variation, Levitt adds, is the question of how many states would expand Medicaid to all of its lowest-income residents under the ACA, compared with how many would do so under the AHCA.
The CMS report also estimates federal spending wouldn't go down as much as CBO predicts; it also predicts an increase, on average, of more than 60 percent in the amount of costs borne by those who buy their own insurance.
CBO estimates those who make more than 400 percent of the federal poverty limit, who don't get financial help paying for their insurance, will be better off than those with lower incomes. It projects gross premiums about 13 percent lower in 2026, but net premiums will be about 5 percent higher once federal and state subsidies are factored in.
Medicaid enrollment, the CMS report says, will be 8 million less under the AHCA than under the ACA in calendar year 2026, "because of more frequent eligibility redeterminations, the repeal of retroactive eligibility, and optional State work requirements for adults."
CMS also finds "the loss of revenue from the repeal of the additional Medicare tax on high-income earners and additional Medicare disproportionate share hospital (DSH) spending" will deplete the trust fund two years sooner than under the ACA, while "the HI actuarial deficit is estimated to increase from 0.73 percent to 1.18 percent."
It remains to be seen whether the AHCA will pass, whether in its current form or not, in the wake of comments by the president on the House-passed AHCA bill. At a lunch meeting with Republican senators, Trump called the existing bill "mean" and said the new bill being worked on by GOP senators will be "generous, kind, (and) with heart" the USA Today report says.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
