If the proposed changes to the Affordable Care Act marketplace move forward, 1.9 million more people could lose health insurance, and nongroup coverage could fall by 2.2 million annually.
These shifts would reduce the federal deficit by $210 bn by 2035, according to estimates from the Congressional Budget Office (CBO).
The U.S. Department of Health and Human Services plans to adjust rules that would also lower enrollment in Medicaid and the Children’s Health Insurance Program.
At the same time, employment-based coverage would grow by 400,000 people each year, the CBO said.
These proposals are based on concerns that easier access to subsidized insurance increases the risk of fraud and reduces program accuracy, according to the department.
The CBO also reviewed the impact of premium tax credits, which helped drive record enrollment under the ACA. These credits are set to expire at the end of the year unless extended by Congress.
If made permanent, enrollment in the marketplace would rise by 7.3 million by 2035, and the federal deficit would grow by $358 bn.
According to a joint statement from Democrats on the House Ways and Means Committee and Senate Finance Committee, the Republican-backed proposals could result in at least 5.7 million people losing coverage.
They said the failure to extend premium tax credits, combined with new rules that limit access, would lead to widespread loss of care.
“Trump and Republicans are opening the floodgates for the biggest theft of health coverage we have ever seen,” the statement said.
Democrats added that while the changes mostly target Medicaid and ACA coverage, they would also raise out-of-pocket costs for privately insured individuals.
Those with employer-based insurance would see average annual increases of $450 for individuals and $950 for families.
They stated, “Republicans have spent 15 years trying to take health care away. Choosing not to extend the credits means millions will lose coverage. The consequences will be theirs to own.”
