Losers would include poor Americans who use Medicaid, as 14 million fewer people would be in the program after 10 years. Poorer and older Americans who buy their own insurance, particularly those in both categories, would also lose coverage. The cost of insurance for a 64-year-old earning about $27,000 would increase to more than $13,000, from $1,700 under the Affordable Care Act, even for states that pared back insurance rules.
The report was sharply critical of the idea that sicker patients could be protected in a system that allowed insurers to charge them higher premiums. In the minority of states it predicted would pursue broad waivers of Obamacare’s insurance regulations, the office said that sick customers would face far higher prices and many would be priced out of the market altogether.
“Over time, less healthy individuals (including those with pre-existing or newly acquired medical conditions) would be unable to purchase comprehensive coverage with premiums close to those under current law and might not be able to purchase coverage at all,” the report said.
Republicans have argued that the bill’s waivers would not hurt insurance access for people with pre-existing health conditions, thanks to state funding devoted to high-risk pools subsidizing their coverage. The C.B.O. essentially dismissed that idea, saying that the state funds would not be enough to protect sick customers from huge bills.