Vox - The most devastating passage in the CBOs report on the Senate health bill

Congratulations Senate Republicans. You have made the House bill even more deadly in order to finance tax cuts for the rich.

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The Congressional Budget Office has released its analysis of the Senate GOP’s Better Care Reconciliation Act, and it’s a bloodbath. The bill is expected to lead to 15 million fewer people with health insurance by 2018 — and 22 million fewer by 2026. But the most devastating of CBO’s conclusions can be found on page eight. There, the Congressional Budget Office says that the BCRA would make decent insurance so expensive that “few low-income people would purchase any plan” at all. Here’s the section:

Under this legislation, starting in 2020, the premium for a silver plan would typically be a relatively high percentage of income for low-income people. The deductible for a plan with an actuarial value of 58 percent would be a significantly higher percentage of income—also making such a plan unattractive, but for a different reason. As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan, CBO and JCT estimate.

A bit of background is helpful. A “silver plan” is an insurance plan that covers 70 percent of a person’s expected healthcare costs. Obamacare’s subsidies were designed to make silver plans affordable and to limit out-of-pocket costs. The BCRA cuts Obamacare’s subsidies and designs its own subsidies around plans that cover 58 percent of expected healthcare costs. Those plans, CBO estimates, will come with deductibles of around $6,000 — which means they would bankrupt many poor people before they ever got through the deductible.

So here is what CBO is saying: The BCRA’s subsidies are too small to make the silver plans affordable for low-income people, and the plans it is trying to make affordable — the ones that cover 58 percent of expected costs — carry such high deductibles that low-income Americans won’t buy them because they won’t be able to afford to use them.