It’s Official: The GOP Proposal that Was Supposed to Cover More People In Fact Does the Exact Opposite

Today, the Congressional Budget Office (CBO) released their new independent analysis of the Republican draft to repeal the Affordable Care Act and impose caps and cuts to Medicaid. According to the analysis, the proposal by Speaker Paul Ryan, Majority Leader Kevin McCarthy, and the GOP Leadership of the U.S. House of Representatives would result in 14 million more uninsured Americans in 2018, and 24 million fewer insured within a decade.

It’s amazing to think, but this proposal would lead to more uninsured Americans than there were prior to passage of the Affordable Care Act. The CBO analysis proves that the short-sighted GOP plan will leave 24 million more Americans uninsured, living sicker, dying younger, and being one emergency away from financial ruin. In California alone 4-5 million would lose care. The scale of consumers losing coverage will have ripple effects throughout the health care system, with public health and economic consequences for everyone.


This proposal would break not just our health system but the promises made by President Trump and members of Congress, who said that they wouldn’t just repeal but replace the Affordable Care Act with something that would cover more people at reduced premiums and cost-sharing–the exact opposite of this new plan. In particular, this GOP proposal viciously cuts and caps Medicaid, when President Trump said many times he would not cut this crucial program that covers over a third of Californians, including over half our children and two-thirds of our nursing home residents.


California Representatives have specific reasons to believe that the impacts will be felt disproportionately in their districts. California saw the greatest percentage reduction of uninsurance of any state, and took specific advantage of the opportunity to expand coverage under Medicaid, which would be particularly hard-hit with these cuts. The CBO estimates that the plan would cut Medicaid by $880 billion over a decade. This is a program that covers 14 million Californians – a third of our state – and nearly half of Central Valley residents. In addition, California already has one of the lowest per capita costs of any Medicaid program in the nation, with minimal opportunities for increased efficiencies or savings, so all additional costs would force real cuts to benefits, services, access, and eligibility.

Even with these awful numbers, the CBO is more optimistic than many about the impact on those who purchase coverage as an individual. But even this rosier forecast predicts higher premiums in the near term and much higher cost-sharing in the longer run. Those who get tax credits, such as through Covered California, on average will see a 40% reduction in the financial help they get to afford coverage. That average tax hike is likely to be felt more in California since the GOP proposals’ flat tax credit would no longer be based on need and California is a state with above-average health costs as well as a higher percentage of lower-wage workers than other states. The tax credit, already reduced, won’t mean as much to California families, and won’t keep up with medical inflation. This will force more families off coverage, creating a smaller and sicker insurance pool that would lead to increased costs for everyone else.

No member of the California Congressional delegation, of either party, should vote for such a proposal that would do such disproportionate harm to their own constituents and to our state’s health system on which we all rely.

Find out more from the Health Access fact sheet detailing California impacts of the proposal.