A new analysis says 21 million more people would have no insurance under the new GOP healthcare bill

Over 20 million more people could go without insurance if the Graham-Cassidy healthcare legislation is enacted into law, according to a study from the Brookings Institution published Friday.

The nonpartisan Congressional Budget Office told lawmakers that it will likely not release a full score of the legislation with coverage effectsMatthew Fiedler and Loren Adler at Brookings used previous CBO models to attempt to determine the new plan's potential effects.

Graham-Cassidy: What you need to know about the new GOP health care bill
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Graham-Cassidy: What you need to know about the new GOP health care bill

The legislation was initially proposed by Senators Lindsay Graham (center) and Bill Cassidy. Cassidy (right of Graham) is a physician in addition to being a lawmaker.

(Photo By Tom Williams/CQ Roll Call)

Many health experts say that waivers in the bill could allow states to remove one of the more popular aspects of Obamacare -- the protection of people with preexisting conditions from being charged more for insurance -- if the deregulation would lower overall health costs.

The legislation also requires states to prove that any new health care system "intends to maintain access to adequate and affordable health insurance coverage for individuals with preexisting conditions."

(Photo: Getty Images)

The bill's current text complies with the conservative-favorite Hyde Amendment, which states that no taxpayer funds shall pay for abortions except in the case of rape, incest or if the mother's life is at risk.

Because of specific Congressional rules, the Senate parliamentarian will have to agree on the structure of the legislative language in blocking federally subsidized programs from including abortion coverage.

Even if the language is blocked, though, the Graham-Cassidy bill would funnel funding through the Children's Health Insurance Program beginning in 2021 -- which is compliant with the Hyde Amendment. 

(Photo: REUTERS/Rebecca Cook)

A study by the Commonwealth Fund estimates that around 15 million to 18 million more Americans would be without coverage by 2020 under the plan.

(Photo: Getty) 

The Brookings Institution estimates the number of people with insurance coverage would drop by around 21 million between 2020 and 2026.

(Getty Images)

The bill would also eliminate the mandate enforcing that everyone either have insurance or pay a penalty.

The Brookings Institution estimates the number of people with insurance coverage would drop by 32 million by 2027.

Beginning in 2020, the bill as law would eliminate Obamacare's Medicaid expansion and ends its marketplace subsidies.

(Photo: Getty)

Under the bill, CNN reports 34 states would receive less federal dollars for health care than they currently do under Obamacare.


According to the study, 21 million more people would be without coverage in 2026 than under the current system. After the large portion of the bill's funding runs out in 2026, that number would skyrocket to 32 million, the study said.

Even that scenario is a best-case one, Adler and Fiedler wrote. From the study (emphasis added):

"This estimate likely understates the reductions in insurance coverage that would actually occur under the Graham-Cassidy legislation, particularly toward the beginning and end of the seven-year period, because it does not account for the challenges states will face in setting up new programs on the bill’s proposed timeline, the possibility that uncertainty about the program’s future will cause market turmoil toward the end of the seven-year period, or the bill’s Medicaid per capita cap and other non-expansion-related Medicaid provisions."

The Brookings analysis also follows a breakdown from the Commonwealth Fund that estimated 15 million to 18 million more Americans would be without coverage by 2020, and 32 million would be without coverage in 2027.

Fiedler and Adler said decreased funding under Graham-Cassidy and uncertainty surrounding the systems states would set up in 2020 added some degree of doubt to their analysis. But they said the most likely scenario is that the study undershoots the number of people that would lose coverage.

If more states were to loosen Obamacare regulations using a waiver system set up in the bill, that number would increase, according to the study.

FLASHBACK: Meet the Republicans who voted against the last repeal attempt

Republicans who voted 'No' on repeal of Obamacare
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Republicans who voted 'No' on repeal of Obamacare

Sen. Susan Collins, R-Maine

(Photo by Mark Wilson/Getty Images)

Sen. Dean Heller, R-Nev.

(Photo By Bill Clark/CQ Roll Call)

Sen. Lisa Murkowski, R-AK

(Photo by Chip Somodevilla/Getty Images)

Sen. Lamar Alexander, R-Texas

(Photo by Zach Gibson/Bloomberg via Getty Images)

Sen. Shelley Moore Capito, R-WV

(Photo by Alex Wong/Getty Images)

Senator John McCain, R-Ariz.

(Photo via REUTERS/Aaron P. Bernstein)

Sen. Rob Portman, R-Ohio

(Photo via REUTERS/John Sommers II)


One of the biggest factors in the potential increase of uninsured would be due to the short timeframe before states shift to block grants and have to set up their own insurance systems.

"States would have only around 15 months to get new policies in place to do so before insurers would need to begin developing products for 2020 and only about 27 months before the new rules would have to be in effect," Fiedler and Adler wrote. "For comparison, the process of drafting and implementing the ACA began close to five years before the new rules would be in effect. It seems likely that many states would simply fail to meet this timeline or meet the timeline only by deploying ineffective policies."

The researchers concluded that the Graham-Cassidy bill would likely cause destabilized individual insurance and Medicaid markets and vastly increase the number of people in the US without coverage.

Read the full study at Brookings »

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