The bill considered the most likely prototype for partial repeal of the Affordable Care Act would result in as many as 32 million more people without health insurance and would double premiums in the individual insurance market, budget scorekeepers said Tuesday.
The by the Congressional Budget Office and the Joint Committee on Taxation was on the impact of passed by the Republican Congress in 2015 and vetoed by President Barack Obama last January. The analysis was conducted at the request of Senate Democrats.
鈥淭he number of people who are uninsured would increase by 18 million in the first new plan year following enactment of the bill,鈥 said the report. That increase could reach 32 million in 2026.
At the same time, CBO and JCT estimate, premiums for those who purchased coverage in the individual insurance market would increase by 20 to 25 percent in the first year, 鈥渁nd premiums would about double by 2026.鈥
Republicans called last year鈥檚 bill a 鈥溾 for what they might try this year, because it was a 鈥渂udget reconciliation鈥 bill that needs only 51 votes to pass in the Senate and cannot be filibustered. Last week the House and Senate passed a budget resolution instructing specific committees to begin work on dismantling the health law, using the same budget reconciliation process.
Only items that directly impact the federal budget can be included in such a bill, however. That meant last year鈥檚 legislation would have repealed most of the ACA taxes that help fund the health law鈥檚 programs, the penalty for individuals who don’t have coverage and the tax subsidies for people to purchase coverage, as well as the funding to expand the Medicaid program. But it could not change the health law鈥檚 regulation of the insurance market, including the provision requiring insurers to sell to people with pre-existing health conditions.
The result, said CBO, would have been fewer healthy people purchasing coverage, which would leave the insurance pool with higher percentage of sick enrollees and drive premiums up. Insurers, according to the report, would likely stop offering coverage in the individual insurance market.

Senate Majority Leader Mitch McConnell and other Republican leaders called last year鈥檚 bill a 鈥渄ress rehearsal鈥 for what they might try this year. (Douglas Graham/CQ Roll Call via Getty Images)
鈥淐BO and JCT estimate that about half of the nation鈥檚 population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took effect,鈥 said the report. And that would rise to 鈥渁bout three-quarters of the population by 2026.鈥
Democrats were quick to pounce on the estimate as evidence that Republicans are on a dangerous path.
鈥淩epeal and delayed replacement is repeal,鈥 outgoing Health and Human Services Secretary Sylvia Burwell told reporters at a briefing. 鈥淐BO has just stated with analytics and real numbers what happens during that interim period鈥 when part of the law is taken away and part remains.
鈥淭oday鈥檚 CBO report is a clear repudiation of the Republicans鈥 misguided plan to repeal the Affordable Care Act,鈥 said Rep. Richard Neal, D-Mass., the ranking Democrat on the House Ways and Means Committee.
Republicans cautioned, however, that last year鈥檚 bill might not be a good reflection of what will happen in the coming weeks and months.
鈥淭he CBO can鈥檛 score the replacement because it hasn鈥檛 been drafted,鈥 wrote GOP health policy analyst Avik Roy . 鈥淏ut its estimates of the impact of (last year鈥檚 bill) are largely meaningless without consideration of what the GOP鈥檚 replacement will look like.鈥
鈥淚t鈥檚 pretty clear that forcing people to buy insurance does not work,” said Rep. Kevin Brady, R-Texas, chairman of the Ways and Means Committee. “Republicans are taking steps to establish a robust health care marketplace based on innovation, competition, and choice鈥攁n important fact today鈥檚 report fails to consider.鈥
This story was updated to add Rep. Brady’s statement when it came out.