How will the American Health Care Act Affect Insurance Rates?

New legislation could cause more Americans to lose health insurance than initially projected.

It has been speculated that up to 20 million Americans could lose their health insurance coverage if the Affordable Care Act (ACA) is repealed without an expansive replacement plan. However, an article published by the Commonwealth Fund suggests that the number is closer to 30 million.

The Congressional Budget Office released its report yesterday on the the impact the American Health Care Act (AHCA) may have on costs and coverage, projecting that 1 in 10 Americans could potentially lose coverage, according to the article.

The ACA resulted in 20 million more individuals gaining insurance due to the law’s provisions, including Medicaid expansion and the pre-existing condition mandate. Other mandates have ensured that patients receive necessary preventive care services and contraceptives at no cost, which has improved and decreased the number of unintended pregnancies.

Additionally, the individual mandate provided patients with a financial incentive to remain insured, which was among the least popular ACA provisions among GOP legislators, and could be repealed under the AHCA.

This year alone, more than 12 million people signed up for coverage through federal and state marketplaces, despite Republican leaders working diligently to create a replacement plan for the health law. Another 7 million people purchased an individual plan off the marketplace, where insurers must comply with the same provisions, according to the article.

The ACA also requires that small-group markets comply with the same rules and regulations as marketplace plans. More than 17 million employees gained coverage through small group plans.

The provision that allows young adults to remain insured through their parents’ coverage through age 26 also decreased the uninsured rate, and has received bipartisan support. This provision alone insured 7 million young adults in 2016. Since the replacement plan does not eliminate the provision, this group will likely not lose their coverage.

Another 11 million Americans have gained insurance through Medicaid expansion, which is in jeopardy if the AHCA is passed, according to the article. The bill would keep the current level of federal funding for states with expanded Medicaid programs until 2019. After 2019, states would receive the same amount of funding for already-enrolled individuals, but receive a lower amount for newer enrollees.

In total, more than 30 million individuals have gained insurance through the ACA’s financial assistance, Medicaid changes, outreach efforts, provisions, and regulations, according to the article.

Both Democrats and some Republicans have criticized the bill. While Republicans do not feel enough was changed from the ACA, Democrats believe that the proposed legislation would harm patients and cause the uninsured rate to skyrocket.

Prior to voting on the bill, lawmakers should have a full understanding of the risks and benefits of repealing and replacing the ACA to ensure that Americans can still access affordable healthcare, according to the Commonwealth Fund.