Today, both the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) released updated estimates of the version of the American Health Care Act (AHCA) passed earlier this month by the U.S. House of Representatives. The legislation is currently under debate in the U.S. Senate.

Highlights:

• CBO estimates that an additional 23 million Americans would lose access to health insurance coverage, compared with current policy;
• The federal government would save $119 billion between 2017 and 2026; and
• Federal revenues would be reduced by $662 billion over the same time frame.

CBO Reduces Expected Number of Americans Who Could Lose Coverage Under AHCA by 1 Million

In its review of the initial version of the AHCA, CBO estimated that 24 million additional Americans, as compared to current policy, would lose access to health insurance over the next 10 years. With the modifications included in the Upton and MacArthur amendments, specifically the additional funding for state-based high-risk pools for some individuals, CBO has lowered that estimate to an additional 23 million Americans. In 2026, 51 million Americans total would be uninsured if the AHCA as currently written were passed into law, compared to the 28 million Americans expected to be uninsured in 2026 under current policy.

The amended version of AHCA would reduce government expenditures by $119 billion over 10 years, compared with the original estimate of $151 million in savings. The reduced savings is due to additional funding for state-based high-risk pools, as well as changes to the calculations for tax subsidies that would be available to individuals purchasing health insurance coverage. The largest areas of savings would come from reduced federal Medicaid funding and from changes to the subsidies currently available to individuals purchasing health insurance through the non-group market.

Joint Committee on Taxation Estimates that AHCA Would Reduce Federal Revenues by $662 Billion

The JCT estimates that AHCA would reduce federal revenues by $662 billion between 2017 and 2026. The AHCA includes a repeal of many of the various taxes included in the Affordable Care Act to finance an expansion of health insurance access, and a repeal of these taxes is the primary factor in the reduction of revenues. One notable change to the final version of the AHCA was a delay in the repeal of the Medicare surtax on high earners. Individuals earning more than $200,000 and couples earning more than $250,000 are currently subject to a 0.9% surtax on additional income, which is attributed to the Medicare trust fund. Originally, this surtax was scheduled to be repealed in 2018; however, the final version of the legislation delayed the repeal until 2023.