The effects of a repeal of ACA

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We give the summary from the CBO report

• Including the budgetary effects of macroeconomic feedback, repealing the ACA would increase federal budget deficits by $137 billion over the 2016–2025 period (see Table 1). 
  
• That estimate takes into account the proposal’s impact on federal revenues and direct (or mandatory) spending, incorporating the net effects of two components: 
  
• • Excluding the effects of macroeconomic feedback—as has been done for previous estimates related to the ACA (and most other CBO cost estimates)—CBO and JCT estimate that federal deficits would increase by $353 billion over the 2016–2025 period if the ACA was repealed.
  
• • Repeal of the ACA would raise economic output, mainly by boosting the supply of labor; the resulting increase in GDP is projected to average about 0.7 percent over the 2021–2025 period. Alone, those effects would reduce federal deficits by $216 billion over the 2016–2025 period, CBO and JCT estimate, mostly because of increased federal revenues.
  
• For many reasons, the budgetary and economic effects of repealing the ACA could differ substantially in either direction from the central estimates presented in this report. The uncertainty is sufficiently great that repealing the ACA could reduce deficits over the 2016–2025 period—or could increase deficits by a substantially larger margin than the agencies have estimated. However, CBO and JCT’s best estimate is that repealing the ACA would increase federal budget deficits by $137 billion over that 10-year period.
  

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It would, of course lead to a lot more people without insurance and other accomplishments of ACA (the end of discrimination on the basis of existing conditions, the fear of losing healthcare when changing jobs or starting one's own company, etc.).

From the CBO again:

Repealing the ACA also would affect the number of people with health insurance and their sources of coverage. CBO and JCT estimate that the number of nonelderly people who are uninsured would increase by about 19 million in 2016; by 22 million or 23 million in 2017, 2018, and 2019; and by about 24 million in all subsequent years through 2025, compared with the number who are projected to be uninsured under the ACA. In most of those years, the number of people with employment-based coverage would increase by about 8 million, and the number with coverage purchased individually or obtained through Medicaid would decrease by between 30 million and 32 million. 

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You might also want to consider this (still from the same CBO report):

Repealing the ACA would cause federal budget deficits to increase by growing amounts after 2025, whether or not the budgetary effects of macroeconomic feedback are included. That would occur because the net savings attributable to a repeal of the law’s insurance coverage provisions would grow more slowly than would the estimated costs of repealing the ACA’s other provisions—in particular, those provisions that reduce updates to Medicare’s payments. The estimated effects on deficits of repealing the ACA are so large in the decade after 2025 as to make it unlikely that a repeal would reduce deficits during that period, even after considering the great uncertainties involved.

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If the next president and Congress repeal Obamacare — as many Republican elected officials want to do — there could end up being more people without health insurance than before the law went into effect, a new study says. A total of 24 million more people would lose health coverage by 2021 if the Affordable Care Act was repealed, according to the study issued Monday by the Robert Wood Johnson Foundation and the Urban Institute. That tally would be added to the 29.6 million who would still be uninsured even if the ACA's various programs had remained in place, for a total of 53.5 million uninsured people. As a result, the uninsured rate would nearly double, to 19.4 percent of the U.S. population by 2021, according to the study.

At the same time, however, federal spending on health care for the nonelderly would be reduced by $927 billion from 2017 to 2026, the report found. But state spending would increase by $68.5 million during the same time frame as the reductions in Medicaid spending "would be more than offset by increases in uncompensated [medical] care," for people who lack health coverage.

Obamacare repeal would lead to 24 million more people without health insurance

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So now you know..

Republican presidential nominee Donald Trump’s healthcare plan would erase all of the coverage gains from ObamaCare and then some, while Democrat Hillary Clinton’s plan would bring the nation’s uninsured rate to another historic low, according to a new analysis.

As many as 25 million people could lose their coverage if Trump becomes president, according to a new study released Friday by the nonpartisan Commonwealth Fund. Most of those people would be low-income and in poor health.

In sharp contrast, 9.6 million more people could have access to healthcare under Clinton. The analysis is the most comprehensive to date about the two candidates' healthcare plans, which are among their biggest policy agendas even if they rarely offer details in stump speeches. It shows that Trump’s plan, which calls for repealing ObamaCare, would have a dramatic effect on both the number of people with coverage and the federal deficit.

Repealing the law — without replacing the revenue from several large taxes — could increase the deficit by as much as $41 billion. Clinton, who has released detailed policy promises to expand ObamaCare, would also have a large effect on the federal deficit, increasing it by as much as $90 billion. Her most expensive policy involves new subsidies for people to cover their out-of-pocket costs, up to $2,500 per person or $5,000 per family. The total cost is estimated to be about $110 billion per year, while also reducing the cost of Medicaid by $25 million.

Study: 25 million could lose health coverage under Trump | TheHill

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HR 3762 would also repeal Obamacare’s mandate. It would end many of Obamacare’s major taxes that helped pay for the health law’s insurance expansion. This includes taxes on health insurers, hospitals, and medical device manufacturers and a Medicare payroll tax of 0.9 percent that the law levied on Americans who earn more than $200,000 (or $250,000 for a married couple). The Congressional Budget Office estimates that 22 million people would lose insurance under this plan after the two-year transition policy ended. These would mostly be people who have coverage through Medicaid and the insurance marketplaces.

Trump and the GOP can absolutely repeal Obamacare — and 22 million people would lose health insurance - Vox

“Studies show that repealing the ACA will force 20 million people into the ranks of the uninsured,” Families USA ‘s Pollack said. Approximately 130 million people with pre-existing conditions will be in danger as insurance companies are once again allowed to discriminate against the sick,” Pollack said. “We will fight at the grass roots level and in the halls of Congress to make sure Mr. Trump’s proposed ACA repeal and Medicaid restructuring don’t happen. Millions of people should not have their lives placed in jeopardy through reckless action.”

The Battle To Save Obamacare Has Begun

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Hall lost her job at a small nonprofit that didn’t offer coverage two weeks into maternity leave. Her husband is a computer programmer who does contract work. “We’re pretty much the definition of the gig economy,” Hall says. Her daughter is now 10 weeks old, and Hall is starting to look for a new job. Initially, she thought she would go to a small startup or nonprofit. But Tuesday, everything changed. And now Hall is reorganizing her job search to focus on places that can offer her family health insurance. She doesn’t want to take a job without coverage, only to find that Obamacare’s insurance expansion is eliminated a few months later.

One of the emails I received was from Joshua Kelly, who lives in California, who told me about his 2-month-old daughter, Clara. She was born with a heart condition but is healthy now. Kelly and his family have insurance at work; they don’t use Obamacare now. But to him, the law represented opportunity that might now be lost: If she ever loses health coverage, when she graduates into an uncertain job market, or if she loses her job, the loss of the Obamacare safety net would make it very expensive for her to see a cardiac specialist. This means she won’t be able to take all kinds of risks with her career. The loss of Obamacare will mean a narrowing of her options, and a future with more uncertainty and fear. This saddens me more than I can put it into words.

“The first thing I thought about was health care”: Trump’s victory through the eyes of Obamacare enrollees - Vox

CNN anchor Jake Tapper grilled House Speaker Paul Ryan on Sunday over whether his Obamacare replacement plan would still provide free birth control to insured women. In an interview on "State of the Union," Tapper asked the speaker and self-styled policy wonk whether his future Obamacare replacement plan would still allow insured women to receive birth control with no additional cost. "Look I'm not going to get into all the nitty-gritty detail of these things," Ryan replied. Tapper continued to drill down on the question. "With all due respect, I don’t know that the average woman of childbearing years out there who relies upon contraception provided by health insurance mandated by the Affordable Care Act I don’t know that she would think that that’s just a nitty-gritty detail," Tapper said.

Jake Tapper grills Paul Ryan over birth control - Business Insider

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Gone from the seven-point list (PDF) Trump put forth during his election campaign is a plan to allow the import of prescription medications. Also gone is a plan to require price transparency in healthcare, something the vast majority of Americans would likely support. There’s also no further mention of reforming mental health programs in the country or making individuals' healthcare premiums tax-deductible.

Instead, the new top issues on Trump’s healthcare plan seem to fit with Republicans’ pro-life stance: to “protect individual conscience in healthcare” and “protect innocent human life from conception to natural death.” The former would shield doctors, pharmacists, and other healthcare providers who refuse to perform or offer services that conflict with their religious or personal beliefs. Such policies are most often used in relation to reproductive issues, such as dispensing of contraception or performing abortions.

Also freshly on the agenda is a plan to “modernize” Medicare, something Republicans, particularly House Speaker Paul Ryan (R-Wis.), have long sought. Ryan’s past plan involved providing Medicare beneficiaries with a chunk of money to purchase private health insurance or a government-run program. Trump’s new agenda also includes a plan to simplify the Food and Drug Administration’s approval process for new drugs and devices with the idea of getting those innovative products to patients faster. This has also long been a top priority for Republicans; the GOP-led House passed such legislation last year. Negotiations in the Senate are ongoing as Democrats have pushed back, arguing that there's a critical need for regulations to ensure product safety.

Trump’s healthcare plans get swift Republican makeover [Updated] | Ars Technica

The latter is likely to involves vouchers and will likely short-change many.

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Not happy with just the ACA..

It has been obvious for a long time that Medicare is actually more efficient than private insurance, mainly because it doesn’t spend large sums on overhead and marketing, and, of course, it needn’t make room for profits.

What’s not widely known is that the cost-saving measures included in the Affordable Care Act, a.k.a. Obamacare, have been remarkably successful in their efforts to “bend the curve” — to rein in the long-term rise in Medicare expenses. In fact, since 2010 Medicare outlays per beneficiary have risen only 1.4 percent a year, less than the inflation rate. This success is one main reason long-term budget projections have dramatically improved.

The Medicare Killers - The New York Times

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Turkey's voting for Christmas..

The biggest impact of an ACA repeal would be the loss of health insurance coverage for an estimated 20 million Americans, including about 11 million who’ve bought policies through the ACA exchanges.

Of these, about 9.4 million receive tax credits to help them afford coverage, according to the most recent figures available from the Centers for Medicare and Medicaid Services (CMS). On average, these subsidies total $291 per month and disproportionately benefit red state consumers. In fact, 68 percent of the beneficiaries of coverage subsidies live in states that voted for Trump.

According to CMS, the ten states with the largest shares of people getting federal help with their premiums are Mississippi, Florida, Louisiana, Wyoming, Alabama, North Carolina, South Carolina, Alaska, Nebraska, and Arkansas. In each of these states, all of which voted for Trump, about nine in ten enrollees receive subsidies to pay for coverage..

Replacing the current tax credit with a deduction—as Trump proposed during the campaign—would also be of little help, given that only 32 percent of Americans itemize deductions on their tax returns.

As many as 129 million people—or more than a third of Americans—have some type of pre-existing health condition, according to the White House.  “People would be surprised about what would count as a pre-existing condition,” says JoAnn Volk, Senior Research Fellow and Project Director at the Georgetown University Center on Health Insurance Reforms. “It could be asthma or a bum knee from playing high school basketball.”

Washington Monthly | Who Loses the Most If Obamacare Is Repealed?

The rest of the article isn't any more uplifting either..