If the next president and Congress repeal Obamacare — as many Republican elected officials want to do — there could end up being more people without health insurance than before the law went into effect, a new study says. A total of 24 million more people would lose health coverage by 2021 if the Affordable Care Act was repealed, according to the study issued Monday by the Robert Wood Johnson Foundation and the Urban Institute. That tally would be added to the 29.6 million who would still be uninsured even if the ACA’s various programs had remained in place, for a total of 53.5 million uninsured people.
As a result, the uninsured rate would nearly double, to 19.4 percent of the U.S. population by 2021, according to the study. “Thus, the uninsurance rate would be higher in 2021 without the ACA than it was in 2013,” the year before the Obamacare law began taking full effect, a report on the study said. In 2013, there were 47.5 million people, representing 17.6 percent of the population, who lacked insurance. Matt Buettgens, senior research associate at the Urban Institute, and a co-author of the report, said, “It would be an unprecedented disruption of coverage.”
At the same time, however, federal spending on health care for the nonelderly would be reduced by $927 billion from 2017 to 2026, the report found. But state spending would increase by $68.5 million during the same time frame as the reductions in Medicaid spending “would be more than offset by increases in uncompensated [medical] care,” for people who lack health coverage.
The ACA implemented three broad programs that are credited with dramatically driving down the uninsured rate since 2013: expansion of Medicaid programs to more poor adults; online marketplaces that sell government-subsidized private health insurance; and allowing younger adults to remain on their parents’ health plans. At the same time, nearly all Americans are now required by law to have some form of health coverage or pay a tax penalty.
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