The long-awaited Congressional Budget Office analysis of the American Health Care Act is out and the news isn’t terribly good for Republicans hoping to avoid major electoral losses in 2018.
According to the CBO, the AHCA will ensure 23 million fewer people than Obamacare by 2026. That’s broadly consistent with the 24 million number the earlier health care legislation pushed by Republicans — but never voted on — produced.
In a bit of good news for Republicans, the AHCA is expected to reduce the deficit by $119 billion, less than the $151 billion estimated in the original bill but still a significant chunk of change.
The details of the CBO report — unstable markets! rising premiums! — will be debated endlessly in Washington and in health care circles around the country.
But, it’s important to remember that the average person has NO idea what the CBO is or does or what its “scoring” means. The public pays only passing attention to these sorts of things that so captivate political Washington. What the average person does care about is bottom lines. And, on that front, Republicans look likely to lose.
There are two big bottom line numbers in this CBO report: 23 million and $119 billion. The question is which matters more: The delta between how many people Obamacare is covering and how many Trumpcare is projected to cover OR the money the country is saving on the debt.
One of these things is an esoteric number. The other is a real-world one. And the latter beats out the former every single time in campaigns.
Consider that for the average person our national deficit is a very, very hard concept to grasp. Sure, we owe lots of money. And, sure, owing that money — particularly to China! — is a bad thing. But, the size of the deficit is not something that has a day in, day out impact on most peoples’ lives. In fact, I’d be willing to wager a large sum of money that the vast majority of people in the country don’t think about the federal deficit more than once a year — if that.
Health care — particularly access to it — is something that touches large swaths of the country on a weekly or monthly — if not daily — basis. It’s something that every single person in the country has experience — and often frustration — with. The idea that 23 million people who would have health care if President Trump and Congressional Republicans do nothing will lose it under Trumpcare is going to be an extremely difficult case to make.
Add to that the fact that House Republicans passed the bill without even knowing how much it would cost or how many people it would leave uninsured makes it all the worse politically speaking.
Imagine this ad running against and endangered House Republican who voted for the AHCA: “Congressman X voted for Donald Trump’s health care plan before he even knew what the bill would do. Now, a non-partisan budgeting agency say the legislation will eliminate health care options for 23 million people.”
Pretty damning, right?
Republicans can — and already are — pushing back against the CBO. “The CBO has a long track record of being way, way off in its modeling, with predictions often differing drastically from what actually happens,” Republican National Committee spokesman Mike reed said in an email sent to reporters shortly after the CBO release.
The problem is that the numbers are the numbers. Not everyone likes the CBO, but they are the gold standard when it comes to analyzing costs and impacts of legislation.
And remember that, in politics, the shortest and most succinct argument almost always wins. The Democratic argument goes like this: “The AHCA will leave 23 million more people uninsured.” The Republican argument? “Well, that number is produced by a group known for not being totally accurate in its predictions and plus we are going to reduce the deficit by some too!”
It’s not even close. That’s a loser for Republicans. And a massive gift for Democrats looking to take back the House — and hold their ground in the Senate — next November.
CORRECTION: This piece has been updated to correctly state the AHCA’s originally estimated deficit reduction.