The Congressional Budget Office’s (CBO) analysis says that Speaker Paul Ryan’s Obamacare repeal bill forces one million Americans to purchase health insurance or pay the bill’s insurance premium surcharge.
Speaker Ryan’s American Health Care Act (AHCA) promised to repeal the individual mandate to require Americans to buy health insurance. Instead, the bill replaces the individual mandate with a 30 percent premium surcharge for Americans that forgo health insurance for longer than 63 days.
According to the CBO report, the Ryan plan would force one million Americans to purchase health insurance. The analysis states:
By the agencies’ estimates, roughly 1 million people would be induced to purchase insurance in 2018 to avoid possibly having to pay the surcharge in the future. In most years after 2018, however, roughly 2 million fewer people would purchase insurance because they would either have to pay the surcharge or provide documentation about previous health insurance coverage. The people deterred from purchasing coverage would tend to be healthier than those who would not be deterred and would be willing to pay the surcharge.
Both House Ways and Means Chairman Kevin Brady (R-TX) and House Energy and Commerce Committee chairman Greg Walden said that the difference between Obamacare and the Speaker’s legislation is that this reform will not force Americans to buy health insurance. Brady said, “The American Health Care Act is a dramatic departure from Obamacare, which forced Americans to buy expensive, one-size-fits-all health insurance. Our legislation gives individuals and families the freedom to access health care options that are tailored to their needs—not Washington’s.”
Walden explained, “Unlike Obamacare, we will not mandate Americans buy insurance plans they don’t want and can’t afford. Instead, we are working to create a system that gives all Americans access to affordable care and the ability to make the decisions that are right for their families.”
Paul Ryan reiterated the rhetoric that his bill does not require people to buy health insurance. He told Fox News, “And if we end an Obamacare mandate that says you must be this one-size-fits-all plan, guess what? People aren’t going to buy that. So of course, they’re going to suggest that if we’re not going to make people do something they don’t want to do, they’re not going to do it.”
The Republican leadership says their bill will repeal the individual mandate, although Cato’s Michael Cannon says that the Ryan bill creates “the functional equivalent of Obamacare’s individual mandate.” Cannon added, “The flip side of tax credits that are available solely to those who purchase health insurance is that those who do not purchase insurance must pay more to the IRS than those who do. Just like a mandate. And since the effective penalty is just an increase in the taxpayer’s income-tax liability, tax credits for health insurance are actually more coercive than ObamaCare’s individual mandate, because the IRS has many more tools it can use to collect the penalty.”