An Update on the Tweaks to Obamacare on the Occasion of Its 50th Repeal Attempt

The House on Wednesday held its 50th vote to repeal and/or alter Obamacare. It went as you might expect: passed the House, won't become law.

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On Wednesday the House of Representatives held its 50th vote to repeal and/or alter Obamacare, this time with the goal of delaying the individual mandate. It went as you might expect: passed the House, won't become law.

If it were to become law, the good news for opponents is that the Congressional Budget Office predicts the federal deficit would be reduced by about $9 billion over the next decade. The bad news is that about 1 million fewer people would get insurance this year, in addition to the one million who probably wouldn't enroll because of the law's botched rollout. (Though that will save an estimated $9 billion, too.)

Your definition of good and bad may vary, depending on your views on the Affordable Care Act. Obamacare exists to, among other things, lower the number of uninsured. House bills like the one considered today — the Suspending the Individual Mandate Penalty Law Equals ("SIMPLE," get it?) Fairness Act — tout reducing the deficit as a plus. Still, that's secondary to revamping the law.  "The individual mandate and tax penalty are the underpinnings of the President’s healthcare plan," reads the GOP seeking to delay said mandate.

Here's how the major proposed and enacted changes to the law play out in the deficit — and the number of insured Americans — so far.

The administration: Keeping the "if you like your plan" fix for two years 

The Obama administration is expected to announce Wednesday that people can keep their non-compliant plans for two more years. As explained by The Incidental Economist, that means:

  • Less spending on subsidies — since fewer people would sign up for subsidized plan.
  • Less revenue from individual mandate fees — since more people would keep their plans.

House Republicans: Delaying the individual mandate by one year

  • The government would spend that $9 billion, mostly from reduced enrollment in Medicaid and CHIP. There would be a $2.8 billion decrease in spending on subsidies. 
  • Those one million people would lose coverage.
  • The CBO also notes that the SIMPLE Act would have less of an effect given how deep into the enrollment period we are and that "some people who would not have signed up for health insurance coverage without the mandate will keep coverage for which they will have signed up by the time the penalty would be removed." 

The administration: Delaying the employer mandate by one year

  • According to the CBO, this will raise the deficit by $12 billion, including a "$10 billion reduction in penalty payments by employers that would have been collected in 2015." 
  • About one million people won't have employer insurance. "Of those who would otherwise have obtained employment-based coverage, roughly half will be uninsured and the others will obtain coverage through the exchanges or will enroll in Medicaid or the Children’s Health Insurance Program." 

(Mostly) Republican-led states: Not expanding Medicaid

  • Less government money going to the state that decided not to expand Medicaid.
  • An estimated five million people are stuck in the Medicaid gap — meaning that people are too poor to participate in the Obamacare exchange but are ineligible for the previous levels of Medicaid coverage.
This article is from the archive of our partner The Wire.