Skip to main content

The context you need, when you need it

When news breaks, you need to understand what actually matters — and what to do about it. At Vox, our mission to help you make sense of the world has never been more vital. But we can’t do it on our own.

We rely on readers like you to fund our journalism. Will you support our work and become a Vox Member today?

Join now

CBO: newest Senate health bill would lead to 16 million fewer insured by 2026

The “skinny” bill would have a major impact.

Samuel Corum/Anadolu Agency/Getty
Andrew Prokop
Andrew Prokop is a senior politics correspondent at Vox, covering the White House, elections, and political scandals and investigations. He’s worked at Vox since the site’s launch in 2014, and before that, he worked as a research assistant at the New Yorker’s Washington, DC, bureau.

The Congressional Budget Office projects that if signed into law, Senate Republicans’ proposed “skinny” health care bill would lead to 16 million fewer people having insurance by the year 2026, according to a newly released score.

The eight-page bill, the Health Care Freedom Act of 2017, was released late Thursday night, just hours before a planned final Senate vote on it. You can read Sarah Kliff’s full explainer on it here — among other provisions, it would eliminate Obamacare’s individual mandate and eliminate the employer mandate through 2024.

Though the Senate bill leaves Obamacare’s subsidies and its Medicaid expansion in place (and doesn’t include the deep Medicaid cuts that were in the House bill), the CBO has long scored the mandates as very powerful, and projects that their elimination would result in far fewer Americans having insurance because they would be able to forgo it without risking a penalty or fearing that they’re violating the law.

If this bill were to be signed into law, the CBO projects that the percentage of Americans with insurance will drop from 90 percent in 2017 to 85 percent in 2026.

Some argue that those newly uninsured people are in fact being freed from being compelled to purchase insurance under a mandate. But the risk is that predominantly healthy people will withdraw from the individual marketplaces and the remaining participants will be sicker — causing premiums to rise for everyone else. This is the scenario often called a “death spiral.”

The CBO scored the bill’s budgetary implications too, finding that overall, it would reduce the deficit by $178 billion over the next 10 years. They project that spending on coverage provisions would drop by about $275 billion in that timespan, while revenues would also drop by about $100 billion.

Now, Senate Republicans are claiming that they don’t actually want this bill to come become law, and are merely trying to pass it as a vehicle to kick-start a conference committee process with the House. But if they do pass this skinny bill, it is entirely possible that the House will also pass it, without making any changes to it, and send it to President Trump’s desk for his signature.

See More:

More in Politics

Podcasts
The Supreme Court abortion pills case, explainedThe Supreme Court abortion pills case, explained
Podcast
Podcasts

How Louisiana brought mifepristone back to SCOTUS.

By Peter Balonon-Rosen and Sean Rameswaram
Politics
Trump’s China policy is nearly the exact opposite of what everyone expectedTrump’s China policy is nearly the exact opposite of what everyone expected
Politics

As Trump heads to China, attention and resources are being shifted from Asia to yet another war in the Middle East.

By Joshua Keating
Politics
Are far-right politics just the new normal?Are far-right politics just the new normal?
Politics

Liberals are preparing for a longer war with right-wing populists than they once expected.

By Zack Beauchamp
The Logoff
Flavored vapes doomed Trump’s FDA headFlavored vapes doomed Trump’s FDA head
The Logoff

Why Marty Makary is out at the FDA, briefly explained.

By Cameron Peters
Politics
Virginia Democrats’ irresponsible new plan to save their gerrymanderVirginia Democrats’ irresponsible new plan to save their gerrymander
Politics

Democrats just handed the Supreme Court’s Republicans a loaded weapon.

By Ian Millhiser
The Logoff
Can Trump lower gas prices?Can Trump lower gas prices?
The Logoff

What suspending the gas tax would mean for you, briefly explained.

By Cameron Peters