At Least 48 Million Could Become Uninsured Under Paul Ryan’s Budget


Written by Igor Volsky

Since Rep. Paul Ryan’s (R-WI) new budget eliminates $1.5 trillion from the Affordable Care Act, cuts $770 billion from Medicaid and reduces Medicare spending by $200 billion, Ezra Klein points out that “it would be very interesting to see an estimate of the uninsured population under Ryan’s budget.” The Congressional Budget Office (CBO) analysis of Ryan’s plan does not provide those numbers, but a rough back-of-the-envelope estimate suggests that at least 48 million Americans could lose their health insurance:

Here is how:

– 33 MILION FROM HEALTH REFORM: The budget repeals the Affordable Care Act’s requirement to purchase health insurance coverage, the provision of subsidies for lower-income Americans, and the expansion of the Medicaid program. In other words, it completely defunds the law’s investment in reducing the number of uninsured. As a recent CBO estimate found, compared with prior law, “the ACA is now estimated by CBO and JCT to reduce the number of nonelderly people without health insurance coverage by 30 million to 33 million in 2016 and subsequent years.”

– 15 MILLION FROM MEDICAID CUTS: The budget would eliminate the existing matching-grant financing structure of Medicaid and would instead give each state a pre-determined block grant that does not keep up with actual health care spending. This would shift some of the burden of Medicaid’s growing costs to the states, forcing them to — in the words of the CBO — make cutbacks that “involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost sharing by beneficiaries—all of which would reduce access to care.” The block grants would reduce federal Medicaid spending by $810 billion over 10 years, decreasing federal Medicaid spending by more than 35 percent over the decade. As a result, economists estimate that states could reduce enrollment by more than 14 million people, or almost 20 percent—even if they are were able to slow the growth in health care costs substantially.

– 1 MILLION FROM MEDICARE AGE INCREASE: The House budget would raise Medicare’s age of eligibility from 65 to 67 by 2034. CBO estimates that while such proposals would reduce Medicare spending by about $150 billion over 10 years, the change would affect roughly 5.4 million seniors. Of this group, about 2.7 million seniors would pick up health insurance offered by employers. Some of the remaining seniors would obtain coverage through Medicaid, qualify for Medicare because they are disabled, or purchase private health insurance in the direct purchase market. But since the House budget would also cut Medicaid and repeal reforms in the Affordable Care Act that would make the direct-purchase market accessible and affordable, many more seniors would become uninsured.

This post was originally published by ThinkProgress.


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AP Photo/Jacquelyn Martin


Jennifer E.
Jennifer E.4 years ago

So much for "Home of the free". Looks like you need to have money to enjoy it.

Dan B.
Dan Brook4 years ago

The regressive Republican Party of No is obstructionist, mean-spirited, thuggish, religiously fanatical, scientifically ignorant, corrupt, hypocritical, xenophobic, racist, sexist, homophobic, evolution and global warming denying, oily, anti-environment, anti-health, anti-consumer, anti-choice, anti-birth control, anti-education, anti-99%, union busting, Medicare and Social Security slashing, fiscally irresponsible, authoritarian, selfish, greedy, out-of-touch, lacking compassion, warmongering, and otherwise dangerous.

NEVER vote for Republicans.

Sherrie Brunell
Sherrie Brunell4 years ago

For those of you who do have health insurance, hold onto it for as long as you can. I miss having it and having a chronic illness means I either go into so much debt I can never get out, or I suffer intense pain, among other symptoms, and could possibly die due to lack of care.

America, land of the free, but only if you have money.

Karen H.
Karen H.4 years ago

How about we take away his salary, along with all his supporters? That should even things out nicely.

Frances C.
Frances C.4 years ago

Paul Ryan tried this before. Now he is back with the same 'help the rich' and screw the middle class and the poor. Take away our Medicare and turn it into a voucher system which no one can afford. Privatize social security which puts it in the volatile stock market which enriches his large donors. Lower taxes on the rich. Why do you think he and other tea party Republicans get millions of dollars from the Koch Brothers, Wall Street, Roves super PAC, and other super pacs from the wealthy.

Edith B.
Edith B.4 years ago

He doesn't have to worry about health care, EVER, Congress has voted themselves perpetual health care. Time for us to kick them off their pedestals, down where the rest of us live.!

Patrick F.
Patrick f.4 years ago

John D. 2001

John Doucette
John Doucette4 years ago

When did we become a country of "I've got mine and screw you"?

Angela M.
Angela Mogin4 years ago

What's 48 million going uninsured when weighed against tax cut for people who make more that $48 million. It's all a question of priorities and the GOP has not been shy about indicating where their interests lie when it comes to easing government burdens on Americans/

Christopher C.
Chris C.4 years ago

“If conservatives can call it Obamacare, every time a family is forced to file for bankruptcy due to a medical misfortune, or a sick child is dropped by his insurance company, or a patient dies because she can’t afford surgery, we get to call it: “Tea Bagger Care.”