# House passes "repeal and replace" **URL:** \ **Category:** Great Debates\ **Created:** [May 4, 2017, 8:53pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871 "2017-05-04T20:53:38Z")\ **Posts on this page:** 20\ **Page:** 30
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 8:45pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/581 "2017-05-07T20:45:23Z")
> [@RTFirefly](#): > > Last week, I had three half-gallons of milk in my fridge. Right now, I only have two. I count that as a net reduction of a half-gallon. > > In actuality, all three of the original half-gallons are gone, thanks to a growing Firebug, and two newer half-gallons are in the fridge. But I’m comparing overall counts, not doing a longitudinal tracking of each container of milk. And if the wording we were discussing was “There will be a net reduction of 24 million insured people by 2026 from our previous estimate,” I would agree. You used “net reduction,” in your description. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [May 7, 2017, 8:49pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/582 "2017-05-07T20:49:31Z")
> [@Bricker](#): > > Yes! I am. Totally open to being wrong, but I figure it must, since right this second less than 11 million are covered. So 24 million losing seems certain to include future potential buyers. > > Or did I make a glaring error? Help me see it. For some reason I think we may be talking past each other, but let me throw this out there. (I’m not going to open the report again in a new window, so these numbers are from memory but pretty close.) CBO estimates that under the ACA, barring surprises, roughly 28 million are projected to be uninsured in 2026. Under AHCA, that number is 52 million. Of the higher number, roughly 9 million would be lost from the exchanges (in part due to the end of the individual mandate, in part due to cost increases for some individuals), about 9 million due to cuts to Medicaid, and the rest due to various factors, by far the biggest is that fewer businesses would offer coverage for employees. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 9:09pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/583 "2017-05-07T21:09:25Z")
Here is a post that discusses the figure: > [@Budget\_Player\_Cadet](#): > > Here are a few mild suggestions if you don’t like that characterization: > [li]Solve the problem without stripping 24 million fucking people of their health care[/li][li](Just repeating this for emphasis) **Solve the problem without stripping 24 million fucking people of their health care** [/li]. > . > . > > Again, I reiterate. If you think this bill is unconstitutional, challenge it in court. If you don’t, then _what the fuck is the problem that’s so goddamn dire that it requires throwing 24 goddamn million people off their fucking health care?!_ > > Even if this were _remotely_ accurate (and I’m not in fact convinced it is), the fact that this “repeal-and-replace” monstsrosity will shove _24 million people_ off health care should be enough to make you realize what a red herring this is. If all the bill is is “repeal-and-replace” and Obamacare did virtually nothing, then how the hell is it throwing 24 million people off health care? This goes beyond “losing” and says “throwing 24 million people off.” Is this an accurate summary on BPC’s part, **Ravenman**? ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [May 7, 2017, 9:19pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/584 "2017-05-07T21:19:51Z")
I think it inaccurately reflects CBO’s findings. It isn’t clear how many of the 9 million would simply not buy coverage because they’d prefer not to. Let’s just say it is 6 million (for all I know it could be 8 million or 1 million, I’m just picking a number for illustrative purposes). That means 18 million are facing “legitimate” healthcare cuts, as Todd Akin might say, which means your concern about how this policy is described seem like a classic attempt at distraction from the real issue. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 9:26pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/585 "2017-05-07T21:26:14Z")
> [@](#): > > Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums. since they say “some,” I don’t know how the numbers break out. Does anyone? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 9:27pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/586 "2017-05-07T21:27:31Z")
> [@Ravenman](#): > > I think it inaccurately reflects CBO’s findings. It isn’t clear how many of the 9 million would simply not buy coverage because they’d prefer not to. Let’s just say it is 6 million (for all I know it could be 8 million or 1 million, I’m just picking a number for illustrative purposes). That means 18 million are facing “legitimate” healthcare cuts, as Todd Akin might say, which means your concern about how this policy is described seem like a classic attempt at distraction from the real issue. I am not concerned; I just stepped to that discussion. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [May 7, 2017, 9:29pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/587 "2017-05-07T21:29:46Z")
> [@Bricker](#): > > since they say “some,” I don’t know how the numbers break out. Does anyone? It doesn’t seem like they break it out. But at least the bar has been moved from “CBO can’t estimate its way out of a wet paper bag” to “I wish they would provide more details!” 🆒 ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [May 7, 2017, 9:35pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/588 "2017-05-07T21:35:49Z")
> [@Bricker](#): > > since they say “some,” I don’t know how the numbers break out. Does anyone? I’m getting this from the .pdf file and the copy/paste is ugly. But 4 million people will lose coverage voluntarily in 2017, due to the end of mandates. In 2018, 14 million more will be uninsured: 6 million in nongroup (exchanges), 5 million in Medicaid, and 2 million in employer group. If more numbers are needed, I’m sure we can find them. ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [May 7, 2017, 9:38pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/589 "2017-05-07T21:38:07Z")
And yes, I’m looking for the missing million. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 9:40pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/590 "2017-05-07T21:40:52Z")
> [@Tee](#): > > And yes, I’m looking for the missing million. That’s the 14 million. What about the 23/24 million that Budget Player Cadet described as being thrown off? ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [May 7, 2017, 9:44pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/591 "2017-05-07T21:44:23Z")
> [@Bricker](#): > > That’s the 14 million. What about the 23/24 million that Budget Player Cadet described as being thrown off? That’s in 2026. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 10:08pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/592 "2017-05-07T22:08:14Z")
> [@Ravenman](#): > > That’s in 2026. Yes, but of that number, how many are people who voluntarily relinquish due to the absence of a mandate? ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [May 7, 2017, 10:16pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/593 "2017-05-07T22:16:08Z")
> [@Bricker](#): > > That’s the 14 million. What about the 23/24 million that Budget Player Cadet described as being thrown off? You’re saying some are losing coverage on purpose, due to the end of mandates? That would be the 4 million immediately and about 6 million (non-group) next year. Any further out than that, and I’m not seeing what the point is. I found what I was looking for, it answers some questions I had. > [@](#): > > CBO and JCT estimate that 48 million people under age 65, or roughly 17 percent of the nonelderly population, would be uninsured in 2020 if the legislation was enacted. That figure would grow to 52 million, or roughly 19 percent of the nonelderly population, in 2026. (That figure is currently about 10 percent and is projected to remain at that level in each year through 2026 under current law .) > > Although the agencies expect that the legislation would increase the number of uninsured broadly, the increase would be disproportionately larger among older people with lower income; in particular, people between 50 and 64 years old with income of less than 200 percent of the FPL would make up a larger share of the uninsured (see Figure 2). ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 7, 2017, 10:42pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/594 "2017-05-07T22:42:39Z")
> [@Tee](#): > > You’re saying some are losing coverage on purpose, due to the end of mandates? That would be the 4 million immediately and about 6 million (non-group) next year. Any further out than that, and I’m not seeing what the point is. The point is that **Budget Player Cadet** (among others) characterized the loss of insurance as “being thrown off.” And the number of people he said were being thrown off was 24 million. I was writing in support of the claim that this number was incorrect, since it included people that voluntarily left (or were estimated to leave) when the mandate ended. ---
**Author:** ![Ravenman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ravenman/32/2929_2.png) [@Ravenman](https://boards.straightdope.com/u/Ravenman)\ **Post date:** [May 7, 2017, 10:45pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/595 "2017-05-07T22:45:43Z")
> [@Bricker](#): > > Yes, but of that number, how many are people who voluntarily relinquish due to the absence of a mandate? Arg, this will teach me about going by memory even after I read the CBO estimate like six times. The 9 million/9 million/few million detail I gave a few posts back was the estimate for 2020, not 2026. I regret the error in describing the right numbers for the wrong year. For 2026, here is how the 24 million breaks out: 14 million fewer due to Medicaid cuts; 7 million fewer due to fewer businesses offering coverage; 2 million fewer on the exchanges (for any reason, either preference or cost), and 1 million for miscellaneous reasons. Let’s just give you that all 2 million fewer on the exchanges is due to preference, not price. That’s still 22 million who, in even greater likelihood, could legitimately claim that their health care is literally being taken away by the bill. I’m starting to revise my opinion on **Budget Player Cadet** ’s statement. Sounds like he was more right than I understood. ---
**Author:** ![Bone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bone/32/407_2.png) [@Bone](https://boards.straightdope.com/u/Bone)\ **Post date:** [May 7, 2017, 10:51pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/596 "2017-05-07T22:51:13Z")
> [@Bricker](#): > > The point is that **Budget Player Cadet** (among others) characterized the loss of insurance as “being thrown off.” And the number of people he said were being thrown off was 24 million. I was writing in support of the claim that this number was incorrect, since it included people that voluntarily left (or were estimated to leave) when the mandate ended. Does it really matter to your central objection to the ACA, and the subsequent favoring of the house bill as the source of this thread? If the figure is 22M instead of 24M, does that change the argument in any meaningful way? I can’t see that it does. I think it’s important to get the underlying facts correct, but they don’t change the argument. ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [May 7, 2017, 10:55pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/597 "2017-05-07T22:55:54Z")
> [@Bricker](#): > > The point is that **Budget Player Cadet** (among others) characterized the loss of insurance as “being thrown off.” And the number of people he said were being thrown off was 24 million. I was writing in support of the claim that this number was incorrect, since it included people that voluntarily left (or were estimated to leave) when the mandate ended. I do think “thrown off” for that number is inaccurate, although what he said is mostly true, and I appreciate his outrage on our behalf. It is still roughly 24 million people uninsured in two years, and the start of what looks like a massive train wreck planned for the future. ---
**Author:** ![Inbred\_Mm\_domesticus](https://avatars.discourse-cdn.com/v4/letter/i/aca169/32.png) [@Inbred\_Mm\_domesticus](https://boards.straightdope.com/u/Inbred_Mm_domesticus)\ **Post date:** [May 7, 2017, 11:34pm UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/598 "2017-05-07T23:34:50Z")
> [@John\_Mace](#): > > **interstate commerce** ,…). And let the states take care of those things that needn’t be federal. If we need to set up some overall principles, that’s one thing, but let the states work out the nitty gritty details themselves. \*\* If they desire to band together (as some smaller states might want to), then fine. I can imagine the New England sates setting up some regional system, or some of the land-large but population-small western states doing the same.\*\* Wouldn’t such regional health insurance systems be subject to regulation by the federal government since interstate commerce is the responsibility of the federal government? That would severely limit the types of regional-universal health insurance coverage programs available. For example, I doubt a plan to have a single payer system in the greater Northeast would be allowed, or its existence would be continually under threat by the composition of the federal government. Many states could not afford a single payer system on their own (e.g. Vermont) and individual states’ plans might be limited if the companies they need to tax are not limited to the state developing the plan. I see no reason to limit our options for obtaining a more equitable society where basic needs are readily met in the name of what is, in the end, really just an interpretation of the responsibilities of state and federal governments. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 8, 2017, 12:16am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/599 "2017-05-08T00:16:05Z")
> [@Bone](#): > > Does it really matter to your central objection to the ACA, and the subsequent favoring of the house bill as the source of this thread? If the figure is 22M instead of 24M, does that change the argument in any meaningful way? I can’t see that it does. I think it’s important to get the underlying facts correct, but they don’t change the argument. No, you’re absolutely right; it’s not even tangential to my argument. But there seemed to be a certain confusion with D’Aconia’s point, so I tried to help clarify. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 8, 2017, 12:21am UTC](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871/600 "2017-05-08T00:21:49Z")
> [@Inbred\_Mm\_domesticus](#): > > Wouldn’t such regional health insurance systems be subject to regulation by the federal government since interstate commerce is the responsibility of the federal government? That would severely limit the types of regional-universal health insurance coverage programs available. For example, I doubt a plan to have a single payer system in the greater Northeast would be allowed, or its existence would be continually under threat by the composition of the federal government. Why? You’re absolutely right that a multi-state plan would be eligible for federal regulation as interstate commerce. But why so confident that this would be fatal? The wisest path is for the Feds to say they won’t, even though they can. [Previous page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=29) [Next page](https://boards.straightdope.com/t/house-passes-repeal-and-replace/785871.md?page=31)