The Urban Institute has done an analysis of the results of the changes made to the Affordable Care Act by Republicans, who failed to kill it off but managed to wound it in major ways. That analysis largely matches that of the Congressional Budget Office — fewer insured, higher costs and less coverage. Oh, and higher taxpayer spending too.
— Eliminating the individual mandate, combined with such lesser acts of vandalism as eliminating cost-sharing reduction payments to insurers last year and eviscerating the outreach and advertising budget for the 2017 ACA open enrollment period: 6.4 million more people uninsured than under previous law, as the uninsurance rate climbs to 12.5% of the nonelderly population from 10.2%.
— Expansion of short-term non-compliant policies: 2.5 million more Americans without minimum essential coverage. Short-term policies, which were limited under the Obama administration to three months maximum and no renewals, would be expanded under Trump to last up to a year. Under the law, short-term policies don’t count as real Obamacare insurance.
— Premiums in the individual market: Higher by 18.2% in 2019 in “full-impact states” (41, plus the District of Columbia, which allow short-term policies under some circumstances.) Eight other states prohibit or limit the expansion of short-term policies, so their premium increases will be lower on average. Nationwide, premiums will rise by 16.4%. In Texas, North Dakota, Alabama, Nebraska and Arizona, the increases will exceed 20%.
— Because government premium subsidies rise in tandem with premium increases, the cost of subsidies borne by the government will rise by $33.3 billion next year, or 9.3% — to $391.4 billion from $358.1 billion under existing law.
So it costs us more money in subsidies, not less, but leaves millions more uninsured and those who are still insured paying higher premiums for less comprehensive coverage. As I said repeatedly when they were putting all this together in Congress, they could not have done any worse if they’d intentionally tried to do the opposite of what they claimed they were doing. Every single thing they think is bad about Obamacare is made worse by Trumpcare, and for more money. It was monumentally stupid.