The headline findings in the Congressional Budget Office’s analysis of the Obamacare repeal bill produced by House Republicans are brutal enough: 24 million Americans losing their health coverage, healthcare costs soaring for many millions more, and the evisceration of Medicaid, all while handing the richest Americans a handsome tax cut.
But in its fine print, the CBO report identified at least seven other ways the GOP proposal—call it Trumpcare, Ryancare, or Wedontcare— would damage the U.S. healthcare system. Some would have effects reaching far beyond the middle- and low-income buyers of insurance on the individual market who are the Affordable Care Act’s chief beneficiaries.
Here they are:
1. Shopping for health insurance will become tremendously more complicated. The Affordable Care Act standardized individual policies into four tiers based on “actuarial value”—the percentage of medical care costs covered by the insurer. The tiers are bronze (60% actuarial value), silver (70), gold (80), and platinum (90). This simplification allows buyers to compare plans on price alone, since every silver plan must offer roughly the same coverage as every other silver plan. Insurers are required to offer at least one silver and one gold plan to participate in the individual marketplaces.
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