The magical, mystical “23 million” who will “lose” health insurance.


Hopefully you watched Mick Mulvaney explain the magical, mystical world of budget “cuts” in the mind of Democrats in Congress. The same sort of thinking underlies the “estimate” that 23 million Americans will lose health insurance coverage under the Republican American Health Care Act (ACHA).

I think it is fair to state that the Congressional Budget Office (CBO) is highly constrained in the math that it must employ (the CBO made the “23 million” estimate). However, no one “explained” that to the Democrats who are screaming “fowl” from the rooftops about the AHCA. Hopefully today’s missive will help you understand that the “23-million-estimate” is mystical and magical.

I previously wrote that the CBO estimate was wrong thinking, but even that exposition doesn’t tell the story. The CBO must only consider bills as written. This is a major reason their estimates are frequently “off.”

[Source: Fact Check: No, the Republican Healthcare Bill Would Not Cause 23 Million People to “Lose” Insurance, by Guy Benson]

The CBO’s analysis of the initial ACHA is deeply misleading. The report (and the left-wing media) leads one to believe that those 23 million Americans currently have health insurance. THEY DON’T!

How is it that Americans can “lose something” they do not have? This is where magical, mystical math comes in. The CBO assumes that most of these people would eventually gain coverage through the magical powers of Obamacare’s individual mandate. They further compute that the hypothetical expansion of Medicaid – somewhat baked into Obamacare – will insure millions more. However, most states demurred on the issue of Medicaid expansion (of course, that doesn’t figure in the CBO estimates).

Current Medicaid beneficiaries, including those covered under Obamacare’s expansion, are grandfathered in under the House GOP proposal.  So they do not get “kicked out” by the “mean-spirited” AHCA (personally, I would kick them out – I’m not as nice as the House Republican caucus).

The CBO also calculates how many will be insured using empirically-incorrect projections that have been disproven by actual data. When Obamacare first passed, CBO anticipated that by 2016, 21 million Americans would enroll in the law’s exchanges. When 2016 rolled around, the real number was just about 10 million. However, and unbelievably, CBO relies on its revised 2016 “baseline” in its new calculations — another CBO computation that was off by millions.

Despite these demonstrable errors, CBO is still using verifiably-disproven, Obamacare-friendly estimates as the basis for comparison. Let’s look at one example. Last year 12.7M “selected a plan.” However, only 11.1M enrolled, but by midyear only 10.4M paid for insurance. Despite this data, CBO assumes 2017 paid enrollment will be 15M. How did they figure that?!?!

Here is the annual error in covered lives of the CBO 2016 and 2017 baseline going forward. Can you rationalize using these outdated projections? These are overestimates in the multiple millions.

When one subtracts Americans who do not actually have coverage under Obamacare but who CBO has decided would hypothetically do so in the years ahead, and substitute actual enrollment numbers only a few million of the “23 million” would actually lose existing coverage. Further, these Americans are NOT LEFT OUT IN THE COLD! They would receive tax credits to purchase new plans (plans that will likely cost less under the AHCA).

I have previously pointed out that millions who are judged to “lose coverage” DO NOT WANT COVERAGE! Affirmatively choosing not to buy a product does not equal “losing coverage.”

The AHCA has multiple layers of protections for people with pre-existing conditions. Could they lose coverage under the AHCA? Yes. But this would require multiple events to occur:

  • First, they must live in a state that waives Obamacare’s “community rating” mandate
  • Second, they don’t remain continuously insured.
  • Third, they must be near-retirement age.

Once again, requiring this group to exercise any degree of personal responsibility is off the table in the minds of the Democrat Party. Additionally, they would let this small group dictate that 320 million Americans need to spend $1.1 trillion over 10 years and not get the benefits that will lead to lower rates for everyone – except those that were given yet another Democrat freebee.

And thanks to MG for sending this to me.

Roy Filly

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About Roy Filly

Please read my first blog in which I describe myself and my goals.
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