"I accept that we will get hit for this", Ryan told Axios.
"There is still much work to be done, but the AHCA is a step towards providing Americans the freedom to choose health plans that are right for them at a cost they can afford, not plans forced on them by Washington bureaucrats", he added. Also, it's likely that insurance companies will negotiate rates to be more attractive to consumers using tax credits - a contingency for which the CBO also does not plan.
Senate Finance Committee Chairman Orrin Hatch, R-Utah, said, "We're still a ways away from having solutions here".
"Over time, it would become more hard for less healthy people (including people with pre-existing medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly", the CBO wrote. "When they run in 2018, they are going to want to say that they lowered average premiums".
On May 4, GOP lawmakers passed the AHCA by a vote of 217 to 213, advancing it to the Senate. He did not explain why the states would somehow pony up this money when they were free from Obamacare regulatory burdens for decades leading up to 2014 and did no such thing. Instead, he discussed a Trump administration report showing that premiums have grown in recent years and accused Democrats of trying to "blame someone other than themselves for the failures of Obamacare". The CBO estimates premiums would fall 10% to 30% in 2026, depending on how numerous regulations stay in place.
The CBO estimated that a 21-year-old making $26,500 would have premiums between $1,750 and $1,250 depending on if their state applied for waivers. But given that Trumpcare would eliminate the employer mandate for large businesses to provide health insurance for their employees, and that businesses were steadily cutting workers from health insurance before Obamacare, it is quite likely that the revised version of the AHCA could leave even more Americans without health insurance. "That's what they wanna give us?"
This is a key point of disagreement between Republicans and the CBO, and would reflect a crucial flaw in the Republican bill. The CBO projected that in states that waived both of these measures, consumers with pre-existing conditions would face substantially higher premiums for individual market coverage, if they could even purchase it at all. "This is really the federal government passing the buck to states and it's incredibly irresponsible", Whiten said. "We will have federal resources and state resources".
But two small-business groups, the Main Street Alliance and the Small Business Majority, said the bill could hurt their members, many of whom rely on the individual insurance market for their coverage. At an income of $68,200, the same person's out-of-pocket cost for premiums could go down slightly from $15,300 to as low as $13,600, if state had a waiver, or increase slightly to $16,100 without a waiver. The law also allows states to opt out of insurance coverage for pre-existing coverage.
Which means, as a practical matter, they have no choice.
But the nonpartisan Congressional Budget Office, which this week released its scorecard on a health care bill that Kinzinger supported, said the legislation wouldn't necessarily protect those with pre-existing conditions. The toughest one to answer, though, may be about the premiums.