Here is the December 2015 analysis from the Congressional Budget Office (CBO) and Congress’ Joint Committee on Taxation about the impact of defunding and partially repealing the Affordable Care Act (ACA). H.R. 3762 was passed by both the Senate and the House in the 114th Congress but vetoed by President Barack Obama in January 2016. Republicans are expected to use the same budget reconciliation process to defund and partially repeal the ACA in the 115th Congress, with the support of President-elect Donald Trump.

The CBO analysis is based on the following actions included in the budget reconciliation bill:

  • Repealing subsidies for health insurance coverage obtained through health insurance exchanges beginning in 2018 and, prior to that year, eliminating the limitation on the amount people would have to repay if the premium tax credit they receive during the year exceeds the allowed amount based on their actual income;
  • Repealing the optional expansion of eligibility for Medicaid that was established in the Affordable Care Act (ACA), beginning in 2018;
  • Eliminating penalties associated with the requirements that most people obtain health insurance coverage and that large employers offer their employees health insurance coverage that meets specified standards, while keeping those requirements in place, beginning in 2016;
  • Repealing the federal excise tax imposed on some health insurance plans with high premiums;
  • Eliminating the Prevention and Public Health Fund and rescinding any unobligated balances of the fund;
  • Repealing a portion of the Medicaid funding provided to U.S. territories;
  • Repealing many of the provisions of the ACA that are estimated to increase federal revenues, including the hospital insurance payroll tax rate for high-income taxpayers, a surtax on those taxpayers’ net investment income, and annual fees on health insurers and medical devices; and
  • Prohibiting federal funds from being made available to certain entities, i.e., Planned Parenthood, that provide abortions for one year.

The CBO estimates that H.R. 3762 would have increased the number of people without health insurance coverage by about 22 million people beginning in 2017. That increase in the uninsured population would consist of 18 million fewer individuals with coverage obtained in the nongroup market (including individual policies purchased through the the ACA’s health insurance exchanges or directly from insurers in the nongroup market) and 14 million fewer individuals with coverage under Medicaid or the Children’s Health Insurance Program, offset by 10 million individuals who would use employment-based coverage.

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