The Congressional Budget Office on Monday released its report on the Senate Republican healthcare bill.
The CBO estimated that the bill, Better Care Reconciliation Act (BCRA), would result in the 22 million fewer people with health insurance by 2026 compared to the current system. That would bring the total uninsured population in the US to 49 million people.
So, where do these coverage losses come from?
Most, according to the CBO, would come from people rolling off Medicaid. The combination of repealing the Affordable Care Act’s Medicaid expansion and lower federal funding for Medicaid would result in low-income Americans dropping off the rolls.
According to the CBO, 15 million fewer people would be on Medicaid in 2026 compared to the current baseline.
In 2026, the CBO also estimated that seven million fewer people who did not have access to coverage through their employer or a program like Medicaid would be without insurance.
House Speaker Paul Ryan and other Republicans have suggested that would come from fewer people choosing to purchase insurance due to the elimination of the Obamacare’s individual mandate.
But while some, especially younger and more affluent people, would choose not to purchase insurance, the CBO estimated that many older and low-income Americans would not get coverage because it would be too expensive. Lower tax credits and a drop in the amount of costs insurers would be required to cover under the BCRA would leave poorer and elderly Americans with higher costs that could be prohibitive in buying insurance.
The CBO also estimated that the repeal of the employer mandate under the BCRA would lead to businesses dropping healthcare benefits from employees and some employees forgoing healthcare benefits, leading to an increase in the uninsured population in the first few years the law would be enacted. A tighter labour market could reduce that predicted drop as employers increase their benefit packages to lure workers.
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