Twenty-four million more people would be uninsured by 2021 if the Affordable Care Act was repealed, according to a report released Monday by the Robert Wood Johnson Foundation.
The drops would come primarily from decreases in Medicaid-eligible people in states that expanded Medicaid and from people who purchase private non-group insurance on the federal exchanges. “Gains in health coverage under the ACA are caused mainly by new enrollment in Medicaid and the marketplaces, so these types of coverage would change the most if the ACA were repealed,” its authors say.
Overall, the report projects there would be 14.5 million fewer people with Medicaid coverage and 8.8 million fewer people with private non-group insurance. An additional 700,000 people would lose employer-sponsored insurance, the report projects.
If the law was repealed, federal spending on health care for non-elderly people would decrease $90.9 billion by 2021 and $927 billion between 2017 and 2026, the report finds. Still, the report also finds that state spending would increase $68.5 billion between 2017 and 2026, mostly because of projected increases in uncompensated care.
“This is not a complete picture of the effect of ACA repeal on the federal budget. Most importantly, revenue-raising provisions of the ACA would also be repealed,” the report says. “Similarly, the difference in direct Medicaid spending is not the only effect on state budgets. In particular, the loss of federal and state spending on health care would have important economic consequences for states.”
The Department of Health and Human Services says that about 20 million people have gained insurance coverage under the Affordable Care Act. Republican lawmakers have tried dozens of times to repeal the health care law, with a repeal bill reaching President Obama’s desk for the first time earlier this year.
Donald Trump, the presumptive Republican presidential nominee, has said the health care law should be repealed and replaced. House Republicans are expected to present a new alternative to the law in the next two weeks as party of their 2016 agenda project.