Este artículo estará disponible en español en El Tiempo Latino.
A preliminary Congressional Budget Office analysis said that a Republican legislative proposal that makes changes to Medicaid and the Affordable Care Act would leave “at least 8.6 million” people without health insurance by 2034. But many Democrats have exaggerated the figure, claiming that 13.7 million would lose their insurance under the proposal.
That higher number includes a CBO estimate for insurance losses under a separate matter — the scheduled expiration of expanded ACA tax credits. The fate of those tax credits is still up in the air, but their extension is not directly tied to the GOP bill before Congress.
For instance, on May 13, during a mark-up session on the budget reconciliation text that the House Committee on Energy and Commerce released May 11, the 13.7 million figure was mentioned several times by multiple Democratic lawmakers.
Rep. Diana DeGette of Colorado, the top Democrat on that committee’s subcommittee on health, said: “For months, Republicans have insisted that they would not cut Medicaid in order to give tax cuts to billionaires. But here they are today with a bill that would do irreparable damage to Medicaid and the millions of Americans it supports. This agenda will kick at least 13.7 million people off of health care coverage according to the nonpartisan Congressional Budget Office.”
Later, Rep. Alexandria Ocasio-Cortez of New York said: “13.7 million people. 13.7 million Americans will be cut off from their health care and made completely uninsurable by the bill that Republicans are presenting today.”
And in a press briefing that day, Senate Minority Leader Chuck Schumer said: “In other heinous news for Americans this weekend, the House Republicans unveiled their plan for the largest cut to Medicaid in American history. The largest cut to Medicaid in American history. 14 million Americans, at least 14 million, would be ripped off of their health insurance under this proposal.”
However, the CBO didn’t say that the legislative proposal alone would increase the number of uninsured individuals by nearly 14 million.
In a May 11 memorandum to the ranking Democrats on three House or Senate committees, the CBO provided its analysis of portions of “the Committee on Energy and Commerce’s reconciliation recommendations,” which were released that day. The committee was tasked with writing health care-related parts of an expansive budget bill that Republicans are trying to pass using the reconciliation process that only requires majority support in the Senate.
Based on the sections it reviewed, the CBO said, “In total, we estimate that the legislation would reduce the number of people with health insurance by at least 8.6 million in 2034.”
That figure included 7.7 million the agency estimated would lose coverage because of proposed changes to the Medicaid program, as well as 900,000 estimated to lose coverage due to changes to enrollment standards for the ACA health insurance marketplaces, which Republicans included in the legislation.
But the CBO, as Democrats requested, also estimated what may happen if Republicans don’t continue ACA premium tax credits that Democrats expanded in 2021 and extended for three years in 2022. Those more generous tax credits, which lowered premiums for beneficiaries, allowing more people to purchase insurance, are set to expire at the end of the year.
“We estimate that the expiration of the expanded premium tax credits will increase the number of people without health insurance by 4.2 million in 2034 relative to an estimate of a permanent extension of those credits,” the CBO said.
Adding 4.2 million to the 8.6 million, plus an additional 900,000 the CBO said could lose coverage because of other changes to ACA marketplace rules proposed by the Trump administration, produces a total of 13.7 million uninsured people. That’s the larger figure that Democrats have been citing recently – although it includes millions of people who wouldn’t directly lose coverage because of the legislation that the CBO reviewed.
(Prior to the committee’s mark-up session on May 13, DeGette posted a video of her explaining the 13.7 million figure better than she did in her opening statement.)
Republicans reportedly are generally opposed to extending the enhanced tax credits, which, if made permanent, would cost $335 billion over 10 years, according to estimates by CBO and the Joint Committee on Taxation. But not every Republican is against it.
Politico reported this month that “a growing number of Republicans have warmed to the idea, including Sens. Lisa Murkowski of Alaska and Thom Tillis of North Carolina and Rep. David Valadao of California.”
Republicans face a “difficult choice,” Politico said. “[S]pend a significant amount of money to extend the subsidies associated with the Democrats’ 2010 health law they largely revile, or let them expire and see out-of-pocket costs rise for voters in an election year.”
Tillis, a member of the Senate Committee on Finance, has suggested working on extending the ACA subsidies after the reconciliation bill is done, according to Axios.
So, the fate of the tax credits is still to be determined, as is CBO’s final estimate of how many people may find themselves uninsured due to the reconciliation bill. The agency said it had yet to analyze other provisions in the legislation, provisions it said it expected would “somewhat further increase” its estimate of “coverage loss” if the bill became law.
But for now, the CBO said that the proposed legislation will increase the number of uninsured by at least 8.6 million, not the 13.7 million figure that Democrats have used.
Editor’s note: FactCheck.org does not accept advertising. We rely on grants and individual donations from people like you. Please consider a donation. Credit card donations may be made through our “Donate” page. If you prefer to give by check, send to: FactCheck.org, Annenberg Public Policy Center, P.O. Box 58100, Philadelphia, PA 19102.