Fwd: JUST RELEASED: Trump Health Care Plan Would Nearly Double Number of Uninsured Americans

-----BEGIN PGP PUBLIC KEY BLOCK----- mQQBBGBjDtIBH6DJa80zDBgR+VqlYGaXu5bEJg9HEgAtJeCLuThdhXfl5Zs32RyB I1QjIlttvngepHQozmglBDmi2FZ4S+wWhZv10bZCoyXPIPwwq6TylwPv8+buxuff B6tYil3VAB9XKGPyPjKrlXn1fz76VMpuTOs7OGYR8xDidw9EHfBvmb+sQyrU1FOW aPHxba5lK6hAo/KYFpTnimsmsz0Cvo1sZAV/EFIkfagiGTL2J/NhINfGPScpj8LB bYelVN/NU4c6Ws1ivWbfcGvqU4lymoJgJo/l9HiV6X2bdVyuB24O3xeyhTnD7laf epykwxODVfAt4qLC3J478MSSmTXS8zMumaQMNR1tUUYtHCJC0xAKbsFukzbfoRDv m2zFCCVxeYHvByxstuzg0SurlPyuiFiy2cENek5+W8Sjt95nEiQ4suBldswpz1Kv n71t7vd7zst49xxExB+tD+vmY7GXIds43Rb05dqksQuo2yCeuCbY5RBiMHX3d4nU 041jHBsv5wY24j0N6bpAsm/s0T0Mt7IO6UaN33I712oPlclTweYTAesW3jDpeQ7A ioi0CMjWZnRpUxorcFmzL/Cc/fPqgAtnAL5GIUuEOqUf8AlKmzsKcnKZ7L2d8mxG QqN16nlAiUuUpchQNMr+tAa1L5S1uK/fu6thVlSSk7KMQyJfVpwLy6068a1WmNj4 yxo9HaSeQNXh3cui+61qb9wlrkwlaiouw9+bpCmR0V8+XpWma/D/TEz9tg5vkfNo eG4t+FUQ7QgrrvIkDNFcRyTUO9cJHB+kcp2NgCcpCwan3wnuzKka9AWFAitpoAwx L6BX0L8kg/LzRPhkQnMOrj/tuu9hZrui4woqURhWLiYi2aZe7WCkuoqR/qMGP6qP EQRcvndTWkQo6K9BdCH4ZjRqcGbY1wFt/qgAxhi+uSo2IWiM1fRI4eRCGifpBtYK Dw44W9uPAu4cgVnAUzESEeW0bft5XXxAqpvyMBIdv3YqfVfOElZdKbteEu4YuOao FLpbk4ajCxO4Fzc9AugJ8iQOAoaekJWA7TjWJ6CbJe8w3thpznP0w6jNG8ZleZ6a jHckyGlx5wzQTRLVT5+wK6edFlxKmSd93jkLWWCbrc0Dsa39OkSTDmZPoZgKGRhp Yc0C4jePYreTGI6p7/H3AFv84o0fjHt5fn4GpT1Xgfg+1X/wmIv7iNQtljCjAqhD 6XN+QiOAYAloAym8lOm9zOoCDv1TSDpmeyeP0rNV95OozsmFAUaKSUcUFBUfq9FL uyr+rJZQw2DPfq2wE75PtOyJiZH7zljCh12fp5yrNx6L7HSqwwuG7vGO4f0ltYOZ dPKzaEhCOO7o108RexdNABEBAAG0Rldpa2lMZWFrcyBFZGl0b3JpYWwgT2ZmaWNl IEhpZ2ggU2VjdXJpdHkgQ29tbXVuaWNhdGlvbiBLZXkgKDIwMjEtMjAyNCmJBDEE EwEKACcFAmBjDtICGwMFCQWjmoAFCwkIBwMFFQoJCAsFFgIDAQACHgECF4AACgkQ nG3NFyg+RUzRbh+eMSKgMYOdoz70u4RKTvev4KyqCAlwji+1RomnW7qsAK+l1s6b ugOhOs8zYv2ZSy6lv5JgWITRZogvB69JP94+Juphol6LIImC9X3P/bcBLw7VCdNA mP0XQ4OlleLZWXUEW9EqR4QyM0RkPMoxXObfRgtGHKIkjZYXyGhUOd7MxRM8DBzN yieFf3CjZNADQnNBk/ZWRdJrpq8J1W0dNKI7IUW2yCyfdgnPAkX/lyIqw4ht5UxF VGrva3PoepPir0TeKP3M0BMxpsxYSVOdwcsnkMzMlQ7TOJlsEdtKQwxjV6a1vH+t k4TpR4aG8fS7ZtGzxcxPylhndiiRVwdYitr5nKeBP69aWH9uLcpIzplXm4DcusUc Bo8KHz+qlIjs03k8hRfqYhUGB96nK6TJ0xS7tN83WUFQXk29fWkXjQSp1Z5dNCcT sWQBTxWxwYyEI8iGErH2xnok3HTyMItdCGEVBBhGOs1uCHX3W3yW2CooWLC/8Pia qgss3V7m4SHSfl4pDeZJcAPiH3Fm00wlGUslVSziatXW3499f2QdSyNDw6Qc+chK hUFflmAaavtpTqXPk+Lzvtw5SSW+iRGmEQICKzD2chpy05mW5v6QUy+G29nchGDD rrfpId2Gy1VoyBx8FAto4+6BOWVijrOj9Boz7098huotDQgNoEnidvVdsqP+P1RR QJekr97idAV28i7iEOLd99d6qI5xRqc3/QsV+y2ZnnyKB10uQNVPLgUkQljqN0wP XmdVer+0X+aeTHUd1d64fcc6M0cpYefNNRCsTsgbnWD+x0rjS9RMo+Uosy41+IxJ 6qIBhNrMK6fEmQoZG3qTRPYYrDoaJdDJERN2E5yLxP2SPI0rWNjMSoPEA/gk5L91 m6bToM/0VkEJNJkpxU5fq5834s3PleW39ZdpI0HpBDGeEypo/t9oGDY3Pd7JrMOF zOTohxTyu4w2Ql7jgs+7KbO9PH0Fx5dTDmDq66jKIkkC7DI0QtMQclnmWWtn14BS KTSZoZekWESVYhORwmPEf32EPiC9t8zDRglXzPGmJAPISSQz+Cc9o1ipoSIkoCCh 2MWoSbn3KFA53vgsYd0vS/+Nw5aUksSleorFns2yFgp/w5Ygv0D007k6u3DqyRLB W5y6tJLvbC1ME7jCBoLW6nFEVxgDo727pqOpMVjGGx5zcEokPIRDMkW/lXjw+fTy c6misESDCAWbgzniG/iyt77Kz711unpOhw5aemI9LpOq17AiIbjzSZYt6b1Aq7Wr aB+C1yws2ivIl9ZYK911A1m69yuUg0DPK+uyL7Z86XC7hI8B0IY1MM/MbmFiDo6H dkfwUckE74sxxeJrFZKkBbkEAQRgYw7SAR+gvktRnaUrj/84Pu0oYVe49nPEcy/7 5Fs6LvAwAj+JcAQPW3uy7D7fuGFEQguasfRrhWY5R87+g5ria6qQT2/Sf19Tpngs d0Dd9DJ1MMTaA1pc5F7PQgoOVKo68fDXfjr76n1NchfCzQbozS1HoM8ys3WnKAw+ Neae9oymp2t9FB3B+To4nsvsOM9KM06ZfBILO9NtzbWhzaAyWwSrMOFFJfpyxZAQ 8VbucNDHkPJjhxuafreC9q2f316RlwdS+XjDggRY6xD77fHtzYea04UWuZidc5zL VpsuZR1nObXOgE+4s8LU5p6fo7jL0CRxvfFnDhSQg2Z617flsdjYAJ2JR4apg3Es G46xWl8xf7t227/0nXaCIMJI7g09FeOOsfCmBaf/ebfiXXnQbK2zCbbDYXbrYgw6 ESkSTt940lHtynnVmQBvZqSXY93MeKjSaQk1VKyobngqaDAIIzHxNCR941McGD7F qHHM2YMTgi6XXaDThNC6u5msI1l/24PPvrxkJxjPSGsNlCbXL2wqaDgrP6LvCP9O uooR9dVRxaZXcKQjeVGxrcRtoTSSyZimfjEercwi9RKHt42O5akPsXaOzeVjmvD9 EB5jrKBe/aAOHgHJEIgJhUNARJ9+dXm7GofpvtN/5RE6qlx11QGvoENHIgawGjGX Jy5oyRBS+e+KHcgVqbmV9bvIXdwiC4BDGxkXtjc75hTaGhnDpu69+Cq016cfsh+0 XaRnHRdh0SZfcYdEqqjn9CTILfNuiEpZm6hYOlrfgYQe1I13rgrnSV+EfVCOLF4L P9ejcf3eCvNhIhEjsBNEUDOFAA6J5+YqZvFYtjk3efpM2jCg6XTLZWaI8kCuADMu yrQxGrM8yIGvBndrlmmljUqlc8/Nq9rcLVFDsVqb9wOZjrCIJ7GEUD6bRuolmRPE SLrpP5mDS+wetdhLn5ME1e9JeVkiSVSFIGsumZTNUaT0a90L4yNj5gBE40dvFplW 7TLeNE/ewDQk5LiIrfWuTUn3CqpjIOXxsZFLjieNgofX1nSeLjy3tnJwuTYQlVJO 3CbqH1k6cOIvE9XShnnuxmiSoav4uZIXnLZFQRT9v8UPIuedp7TO8Vjl0xRTajCL PdTk21e7fYriax62IssYcsbbo5G5auEdPO04H/+v/hxmRsGIr3XYvSi4ZWXKASxy a/jHFu9zEqmy0EBzFzpmSx+FrzpMKPkoU7RbxzMgZwIYEBk66Hh6gxllL0JmWjV0 iqmJMtOERE4NgYgumQT3dTxKuFtywmFxBTe80BhGlfUbjBtiSrULq59np4ztwlRT wDEAVDoZbN57aEXhQ8jjF2RlHtqGXhFMrg9fALHaRQARAQABiQQZBBgBCgAPBQJg Yw7SAhsMBQkFo5qAAAoJEJxtzRcoPkVMdigfoK4oBYoxVoWUBCUekCg/alVGyEHa ekvFmd3LYSKX/WklAY7cAgL/1UlLIFXbq9jpGXJUmLZBkzXkOylF9FIXNNTFAmBM 3TRjfPv91D8EhrHJW0SlECN+riBLtfIQV9Y1BUlQthxFPtB1G1fGrv4XR9Y4TsRj VSo78cNMQY6/89Kc00ip7tdLeFUHtKcJs+5EfDQgagf8pSfF/TWnYZOMN2mAPRRf fh3SkFXeuM7PU/X0B6FJNXefGJbmfJBOXFbaSRnkacTOE9caftRKN1LHBAr8/RPk pc9p6y9RBc/+6rLuLRZpn2W3m3kwzb4scDtHHFXXQBNC1ytrqdwxU7kcaJEPOFfC XIdKfXw9AQll620qPFmVIPH5qfoZzjk4iTH06Yiq7PI4OgDis6bZKHKyyzFisOkh DXiTuuDnzgcu0U4gzL+bkxJ2QRdiyZdKJJMswbm5JDpX6PLsrzPmN314lKIHQx3t NNXkbfHL/PxuoUtWLKg7/I3PNnOgNnDqCgqpHJuhU1AZeIkvewHsYu+urT67tnpJ AK1Z4CgRxpgbYA4YEV1rWVAPHX1u1okcg85rc5FHK8zh46zQY1wzUTWubAcxqp9K 1IqjXDDkMgIX2Z2fOA1plJSwugUCbFjn4sbT0t0YuiEFMPMB42ZCjcCyA1yysfAd DYAmSer1bq47tyTFQwP+2ZnvW/9p3yJ4oYWzwMzadR3T0K4sgXRC2Us9nPL9k2K5 TRwZ07wE2CyMpUv+hZ4ja13A/1ynJZDZGKys+pmBNrO6abxTGohM8LIWjS+YBPIq trxh8jxzgLazKvMGmaA6KaOGwS8vhfPfxZsu2TJaRPrZMa/HpZ2aEHwxXRy4nm9G Kx1eFNJO6Ues5T7KlRtl8gflI5wZCCD/4T5rto3SfG0s0jr3iAVb3NCn9Q73kiph PSwHuRxcm+hWNszjJg3/W+Fr8fdXAh5i0JzMNscuFAQNHgfhLigenq+BpCnZzXya 01kqX24AdoSIbH++vvgE0Bjj6mzuRrH5VJ1Qg9nQ+yMjBWZADljtp3CARUbNkiIg tUJ8IJHCGVwXZBqY4qeJc3h/RiwWM2UIFfBZ+E06QPznmVLSkwvvop3zkr4eYNez cIKUju8vRdW6sxaaxC/GECDlP0Wo6lH0uChpE3NJ1daoXIeymajmYxNt+drz7+pd jMqjDtNA2rgUrjptUgJK8ZLdOQ4WCrPY5pP9ZXAO7+mK7S3u9CTywSJmQpypd8hv 8Bu8jKZdoxOJXxj8CphK951eNOLYxTOxBUNB8J2lgKbmLIyPvBvbS1l1lCM5oHlw WXGlp70pspj3kaX4mOiFaWMKHhOLb+er8yh8jspM184= =5a6T -----END PGP PUBLIC KEY BLOCK----- > Highlights: > > > > By our estimates, Mr. Trump’s plan to repeal and replace Obamacare would cost roughly $270 billion over ten years including estimates of faster economic growth, and nearly $500 billion under conventional scoring. > > The policies would cause almost 21 million people to lose their insurance coverage, as the replacement health care policies would only cover 5 percent of the 22 million individuals who would lose coverage upon the repeal of Obamacare. This would almost double the number of Americans without health insurance. > > > <https://act.myngp.com/el/-5873265016806438912/2784488508956739584> > The nonpartisan Committee for a Responsible Federal Budget has completed an independent analysis of Donald Trump’s health care plan. The analysis shows that the number of uninsured Americans would nearly double under his plan. It also shows that his plan to repeal and replace Obamacare will cost almost $500 billion over a decade—or $270 billion if economic growth impacts are included. > > The full text follows: > > Fiscal FactCheck: Analysis of Donald Trump's Health Care Plan <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > March 14, 2016 > > Read the analysis. <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > > Republican presidential candidate Donald Trump recently released a health care reform plan <https://act.myngp.com/el/-5873265016806438912/3000661291070523392> entitled “Healthcare Reform to Make America Great Again.” This plan has two major components. First, it would fully repeal the Affordable Care Act (“Obamacare”) and replace it with several new policies. Second, it would turn Medicaid into a “block grant” program. > > By our estimates, Mr. Trump’s plan to repeal and replace Obamacare would cost roughly $270 billion over ten years including estimates of faster economic growth, and nearly $500 billion under conventional scoring. > > The policies would cause almost 21 million people to lose their insurance coverage, as the replacement health care policies would only cover 5 percent of the 22 million individuals who would lose coverage upon the repeal of Obamacare. This would almost double the number of Americans without health insurance. > > Block granting Medicaid, meanwhile, could have a wide range of savings depending on details which have yet to be provided. Past proposals have often saved several hundred billions of dollars. > > The Cost of Repealing and Replacing Obamacare > > In total, we estimate Mr. Trump’s “repeal and replace” plan for Obamacare would cost nearly $500 billion over ten years under conventional scoring and about $270 billion with dynamic scoring. > > The largest component of this estimate comes from the “repeal.” The campaign website proposes to “completely repeal Obamacare,” which we assume to mean repealing the Affordable Care Act’s regulations, subsidies, Medicaid expansion, Medicare savings, and tax increases. Although repealing the coverage provisions would save about $1.1 trillion, based on Congressional Budget Office (CBO) estimates <https://act.myngp.com/el/-5873265016806438912/3072718885108451328> (adjusted for recent legislation and changes in the budget window), repealing the legislation’s tax increases and Medicare cuts would cost a combined $1.5 trillion. In total, this means repeal would cost $420 billion – or $200 billion including the economic benefits of repeal. > > <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > Meanwhile, Mr. Trump’s plan to replace Obamacare would entail further costs. Most significantly, Mr. Trump would create a tax deduction <https://act.myngp.com/el/-5873265016806438912/3144776479146379264> for individuals buying their own health insurance. This would equalize the tax treatment between individually-purchased and employer-provided health insurance <https://act.myngp.com/el/-5873265016806438912/3216834073184307200>, but at a cost of roughly $100 billion over ten years. > > The cost of these policies would partially be offset by savings from expanding <https://act.myngp.com/el/-5873265016806438912/3288891667222235136?storyId=121430723> prescription drug importation and re-importation and allowing <https://act.myngp.com/el/-5873265016806438912/3360949261260163072> people to purchase insurance across state lines. Policies to require price transparency and promote health savings accounts will likely have small effects in opposite directions, roughly canceling each other out.1 <https://act.myngp.com/el/-5873265016806438912/3433006855298091008> As a result, the replacement plan would cost $70 billion. > > The total cost of Mr. Trump’s repeal and replace health care plan would be $270 billion over a decade under dynamic scoring and nearly $500 billion under conventional scoring. Those numbers would be smaller (and the direction could differ) if he retained some of the Medicare cuts and/or tax increases from Obamacare > > Note that this analysis does not include Mr. Trump’s call to negotiate aggressively for Medicare drugs, a policy that is not listed on his website. He has previously claimed <https://act.myngp.com/el/-5873265016806438912/3505064449336018944?lite> that $300 billion a year could be saved through negotiation, a claim we rated as false <https://act.myngp.com/el/-5873265016806438912/3577122043373946880> because Medicare will only spend an average of $111 billion each year on prescription drugs. Based on previous estimates by CBO, actual savings would likely be small or negligible. > > The Coverage Impact of Repealing and Replacing Obamacare > > According to CBO, about 27 million Americans will lack health insurance coverage in 2018. Repealing Obamacare would increase that number by 22 million, whereas Mr. Trump’s replacement plan would only increase coverage by 1.1 million. In other words, the plan would increase the number of uninsured individuals by about 21 million and only cover about 5 percent of individuals that would lose coverage from Obamacare repeal. > > The 1.1 million of gained coverage comes from the policies to allow insurance companies to sell across state lines, which would increase coverage by 400,000, and the deduction for individual health insurance, which would increase coverage by 700,000. (Estimates from CBO <https://act.myngp.com/el/-5873265016806438912/3649179637411874816>) Other elements of Mr. Trump’s replacement plan might reduce costs but would not significantly impact coverage. > > <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > Note that these estimates do not account for Mr. Trump’s call <https://act.myngp.com/el/-5873265016806438912/3793294825487730688> to require insurance companies to cover individuals with pre-existing conditions – a policy not listed on his website. Doing so without penalties or subsidies to encourage individuals to purchase insurance, according to CBO <https://act.myngp.com/el/-5873265016806438912/3865352419525658624>, would actually further increase the number of uninsured individuals. > > Block Granting Medicaid > > In addition to repealing and replacing Obamacare, Mr. Trump proposes to transform Medicaid into a block grant to the states. Effectively, this means replacing the current system where the federal government pays for a portion of state Medicaid costs (based on a matching rate) with a system where the federal government gives each state a fixed allotment of dollars each year. > > Not surprisingly, the amount of money this proposal would save (or cost) depends entirely on the size of that allotment, and how much it grows each year. For example, block grants could be designed to maintain current projected spending levels, or they could be designed to save hundreds of billions of dollars (last year’s House budget resolution <https://act.myngp.com/el/-5873265016806438912/3937410013563586560> assumed over $900 billion in Medicaid savings). However, the Trump campaign has not provided any information on the size of their proposed block grants, making it impossible to score any savings. > > To offer some examples, we assumed block grants would be offered at current levels (excluding the Obamacare expansion) in 2017 but then indexed to grow more slowly than current law. Indexing block grants to per person Gross Domestic Product would only save $25 billion over the next decade; freezing block grants in nominal dollars would save nearly $850 billion. Practically any combination is possible. > > <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > If Mr. Trump intends to generate aggressive savings from block granting Medicaid, it could more than pay for the cost of repealing and replacing Obamacare – though perhaps at the cost of a further reduction in coverage. > > * * * * * > > As our analysis above shows, Mr. Trump’s plan to repeal and replace Obamacare – based on the details available – would both add to the deficit and significantly reduce coverage. Meanwhile, his plan to block grant Medicaid could generate significant savings; however, insufficient details are available to estimate if there are any and how much. > > These changes are for the most part2 <https://act.myngp.com/el/-5873265016806438912/4009467607601514496> in addition to Mr. Trump’s other policy proposals, which we’ve estimated would cost between $12 and $15 trillion, <https://act.myngp.com/el/-5873265016806438912/4081525201639442432> driving debt to somewhere between 115 and 140 percent of the economy in ten years. As the campaign proceeds, we hope that Mr. Trump will present additional policies to pay for his proposals and put debt on a more sustainable path. > > 1 <https://act.myngp.com/el/-5873265016806438912/4153582795677370368> Mr. Trump also has proposed to promote price transparency to allow individuals to shop for the best price for each procedure and to promote health savings accounts (HSAs). With regards to price transparency, the Congressional Budget Office found that the effect on prices would be ambiguous <https://act.myngp.com/el/-5873265016806438912/4225640389715298304>, and in our view savings would likely be positive but small. In terms of HSAs, it is not clear how Mr. Trump’s policies would differ from current law. His website says that his plan would “allow individuals to use health savings accounts” and that contributions should be tax-free, allowed to accumulate, and available to family members without penalty. All of these items are already true under current law, and Mr. Trump’s additional proposal to allow HSAs to be passed to heirs will likely have a very small cost. If he intends to expand these accounts so that individuals without high-deductible plans could use them or to increase the limit on contributions, the proposal could have significant costs. However, we assume only a small cost based on the ideas specifically articulated in the press and scores of previous modest HSA proposals. > > 2 <https://act.myngp.com/el/-5873265016806438912/4297697983753226240> There is one policy, repealing the Affordable Care Act’s 3.8 percent surtax on investments, that is included both as a part of Mr. Trump’s health plan and as a part of Mr. Trump’s tax plan. When we update our tally of the total cost of Mr. Trump’s policies, we would remove this double counting and account for interest costs from this health plan > > Read the analysis. <https://act.myngp.com/el/-5873265016806438912/2856546102994667520> > <https://act.myngp.com/el/-5873265016806438912/4369755577791154176> > > Committee for a Responsible Federal Budget > 1900 M Street NW > Suite 850 > Washington DC 20036 United States > > If you believe you received this message in error or wish to no longer receive email from us, please unsubscribe <https://act.myngp.com/el/-5873265016806438912/2712430914918811648>. > >