It’s a devastating report for the Republican plan, and it can be summed up in one chart:
But to understand who will become uninsured, first we have to understand whom Obamacare gave insurance to.
This chart shows how Obamacare lowered uninsurance rates — the share of Americans who don’t have health insurance — from about 16 percent to less than 10 percent:
But as CBO points out, about half the people who gained insurance did so through the expansion of Medicaid, the health insurance program for low-income Americans. Obamacare expanded Medicaid so that, for the first time, it covered everyone making under 138 percent of poverty in the 31 states that chose to expand the program. So Obamacare had an outsize impact on lower-income Americans:
The Republican plan would reverse this — and then some.
After 2020, the Republican plan ends the expansion. Anyone whom Medicaid didn’t cover before Obamacare — in many states, poor adults who aren’t parents or the elderly — would no longer be able to get coverage. It would contribute to one in five Americans being uninsured.
In other words, CBO projects that 24 million people would lose their health insurance by 2026.
The Republican plan also changes who gets help buying insurance. Obamacare gave more help to poor and older Americans — those who need the most help buying insurance. The Republican plan gives you more help as you get older, but not more help if you don’t have money.
So if you’re a poor American, you don’t get that much more help than your middle-class neighbor.
But if you’re a middle-class American — especially a relatively young one — you get more help buying insurance.
Here’s data from the Kaiser Family Foundation. (CBO had similar data, but I think this illustrates it better.)
So what do Republicans get in exchange for kicking 24 million people off health insurance? CBO projects this new plan will cut the deficit by $67 billion in 2020 and $171 billion in 2026.
Here’s what that would do to the deficit:
And keep in mind: Republicans also want tax reform, which would cut taxes on the wealthy and corporations.
So in short, the plan lowers the deficit and benefits the wealthy and the middle class by pulling money out of the pockets of the people who need the most help.