--- title: AHCA: Will the Republican Health Care Bill Lower Premiums? description: It's more complicated than GOP leaders say canonical: https://time.com/4794400/health-care-premiums/ author: Sam Frizell article:opinion: false article:content_tier: free article:published_time: 2017-05-25T19:11:49.000Z article:modified_time: 2026-10-08T09:04:20.500Z article:section: Politics og:title: Will the Republican Health Care Bill Really Lower Premiums? og:description: It's more complicated than GOP leaders say og:url: https://time.com/4794400/health-care-premiums/ og:site_name: TIME og:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt00bba8faa7e970e1/6988cef98e0601bb9846a882/gettyimages-688309976.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 og:image:width: 3000 og:image:height: 1688 og:image:alt: House Speaker Paul Ryan Holds Weekly Press Briefing At The Capitol og:type: article twitter:card: summary_large_image twitter:title: Will the Republican Health Care Bill Really Lower Premiums? twitter:description: It's more complicated than GOP leaders say twitter:image: https://static.time.com/v3/assets/bltea6093859af6183b/blt00bba8faa7e970e1/6988cef98e0601bb9846a882/gettyimages-688309976.jpg?branch=production&width=1200&quality=75&auto=webp&crop=16:9 video:duration: 01:39 video:published: 2017-05-24 section: politics topics: federal budget, health care reform, insurance competition, tax breaks, program cuts, taxpayers, states' rights genre: news clip, political debate tones: partisan, contentious, assertive emotions: confidence (medium), anger (medium), concern (medium) sentiment: neutral audience: voters, policy observers, taxpayers, health care consumers organizations: Republican Party content_suitability: politics [00:12-01:39]; health controversy [00:59-01:23]; financial distress [01:18-01:23] transcript_source: publisher captions transcript_reviewed: not applicable ---  # Will the Republican Health Care Bill Really Lower Premiums? > Sponsored content. 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Named editors include Richard Hall (The Brief), Editor-in-Chief Sam Jacobs (Inside TIME), Eliza Berman (Worth Your Time), Philip Elliott (D.C. Brief), Justin Worland (Future Proof) and Harry Booth (In the Loop). Health Matters is written by TIME's health desk. #### How do I sign up for a TIME newsletter? Go to time.com/newsletters, choose the newsletters you want and enter your email address. There is no cost and no subscription requirement. ### Sources * TIME Newsletters: [time.com/newsletters](/c/time-nl-network-2026q3/newsletters?i=e511d193-2e30-4280-be21-f578612dfc23&cr=time-nl-network-2026q3-v1) ## Video: Republican Health Care Bill Would Lead to 23 Million Fewer Americans With Insurance [Watch (HLS stream): Republican Health Care Bill Would Lead to 23 Million Fewer Americans With Insurance](https://cdn.jwplayer.com/manifests/jEVh4WPC.m3u8) (1:39)  _Published 2017-05-24. The Republican bill to repeal Obamacare would result in 23 million fewer people having health insurance by the year 2026, according to a long-awaited and nonpartisan forecast, upending the healthcare system and scrambling insurance markets._ Description, summary, key points, chapters, key quotes, questions and transcript, where present, were produced automatically from the video or its captions and were not reviewed. ## Summary A short clip presents two opposing views on a Republican budget and health care proposal. One speaker frames the budget through the eyes of taxpayers and calls for more consumer choice, insurance competition, and power returned to the states. A second speaker criticizes the budget for providing tax breaks to billionaires and corporate CEOs while cutting programs that struggling Americans depend on. The clip is mostly bracketed by music and applause. ## Key points - The speaker says the budget should be viewed through the eyes of the people who pay the bills, meaning taxpayers. (00:18) - The speaker says lawmakers have spent too little attention on taxpayers and too much on recipients of taxpayer money. (00:28) - The speaker calls for giving people more choices and more control over their health care. (00:59) - The speaker calls for making insurance companies compete for customers' business. (01:04) - The speaker calls for returning power from Washington to the states. (01:12) - A second speaker says the budget provides massive tax breaks for billionaires and corporate CEOs. (01:15) - The second speaker says the budget makes massive cuts to programs that tens of millions of struggling Americans depend upon. (01:18) ## Chapters - [00:00 to 00:59] Taxpayer-focused budget framing. A speaker argues the budget should be viewed through the eyes of taxpayers rather than program recipients. - [00:59 to 01:15] Calls for health care choice and competition. A speaker calls for more consumer choice, insurance company competition, and power shifted to the states. - [01:15 to 01:39] Critique of tax breaks and program cuts. A second speaker criticizes the budget for tax breaks to wealthy individuals and cuts to programs that many Americans rely on. ## Key quotes - [00:18] Unidentified speaker: "We looked at this budget Through the eyes of the people who are actually paying the bills." - [00:59] Unidentified speaker: "Let's give people more choices and more control over their care." - [01:04] Unidentified speaker: "Let's make insurance companies come in and compete for your business." - [01:15] Unidentified speaker: "This is a budget that provides massive tax breaks For billionaires and corporate CEO's and massive cuts to programs that tens of millions of struggling Americans depend upon." ## Questions this video answers - How does one speaker say the budget should be viewed? [00:12] - What health care reforms does the first speaker propose? [00:59] - What does the second speaker say the budget does for billionaires and corporate CEOs? [01:15] - What does the first speaker say should happen to power currently held in Washington? [01:12] ## Content suitability - politics [00:12-01:39]: Partisan political debate over a federal budget and health care policy. - health controversy [00:59-01:23]: Contested claims about health insurance and cuts to programs people depend on. - financial distress [01:18-01:23]: Mention of cuts affecting tens of millions of struggling Americans. by [Sam Frizell](https://time.com/author/sam-frizell/) ## Sam Frizell May 25, 2017 7:11 PM UTC The Republican bill to repeal Obamacare would result in 23 million fewer people having health insurance by the year 2026, according to a long-awaited and nonpartisan forecast, upending the healthcare system and scrambling insurance markets. by [Sam Frizell](https://time.com/author/sam-frizell/) ## Sam Frizell May 25, 2017 7:11 PM UTC Republicans had one top priority for their health care bill: it had to lower insurance premiums. “The price has to come down, period,” Rep. David Brat of Virginia told TIME in March. Lowering premiums was the biggest sticking point for getting the bill out of the House. So when the Congressional Budget Office released a dismal forecast for the American Health Care Act, projecting 23 million fewer people would have insurance under the Republican law in 10 years, House Speaker Paul Ryan tried to focus on the bright side. “What CBO just told us is the reforms we put in this bill will help lower premiums, and so I’m very encouraged by that,” Ryan told reporters Thursday. But such predictions are difficult, particularly in health care. The picture the CBO gave is more complicated than Ryan portrayed. Because of uncertainty in the law and the way that it’s implemented, what actually happens to insurance premiums depends in large part on factors that are outside Ryan’s control. Patients’ premiums would be determined by everything from how old they are to where they live, whether they have a preexisting medical condition, and how their individual states decide to handle the new law. The CBO predicts that in the short-term, the Republican bill will raise premiums significantly nationwide compared with current law. That means premiums would be higher under the Republican bill in 2019 (by an estimated 20%) and 2020 (an additional 5% higher) than they would be if no changes were made to Obamacare. So if Ryan is referring to just the next couple of years, the AHCA would do the opposite of what Republicans lawmakers intend it to do. After 2020, premiums would depend largely on state choices: —In states that keep the current Obamacare regulations, premiums would fall to about 4% lower in 2026 than under current law. That means Ryan is correct that premiums will eventually go down on average—albeit slightly—for people buying their own healthcare on the marketplace, according to the CBO. —In states that choose to ditch some Obamacare regulations, premiums would go down significantly compared with current law. The CBO estimates premiums would fall 10% to 30% in 2026, depending on how many of the regulations stay in place. But while premiums will be lower, the plans will offer less coverage, because they won’t be required to cover things like emergency services or prescription drugs, depending on what rules each state decides on. —In states that opt-out of _all_ the crucial Obamacare regulations, average premiums will also drop. For younger and healthier people, health insurance will be significantly cheaper in these states. But for people with medical conditions, or older insurance buyers, premiums will be “extremely high,” according to the CBO. “Over time, it would become more difficult for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly,” the CBO said. This is a key point of disagreement between Republicans and the CBO, and would reflect a crucial flaw in the Republican bill. Ryan suggested that on this point, the CBO score misrepresents reality, because states would establish and fund their own high-risk pools, which would cordon off people with preexisting conditions into a separate market. According to Ryan and leading Republicans who helped write the AHCA, the high-risk pools will ensure that those with preexisting conditions do not face significantly higher premiums. “States will also do some of the lifting,” Ryan said. “We will have federal resources and state resources.” But states have tried high-risk pools in the past, and they don’t have a great record. Thirty-six states, including Florida and Texas, had high-risk pools before Obamacare was signed into law, and premiums were often 150% to 200% higher than in the rest of the market. Moreover, the pools lost significant amounts of money. In 2011, high-risk pools faced $1.2 billion in losses for just 225,000 enrollees — likely much fewer than there would be under the AHCA. We don’t know how the high-risk pools will work in the future, how much states will contribute and whether federal funding will be nearly enough. But premiums will likely never be lower than they are today, considering the trend in health cares costs. In addition, even in states that do not cut their Obamacare regulations, the Republican healthcare bill allows insurers to charge older people five times more than younger counterparts, while cutting Obamacare subsidies significantly. That means that even if average premiums go down, some people would likely see their premiums rise significantly. Republicans in the Senate will have to consider plenty of questions as they rewrite the House bill, including the total number of insured under their bill, the stability of health care markets and whether they can cut deficits. The toughest one to answer, though, may be about the premiums. ## Transcript [00:12] [ APPLAUSE ] [ MUSIC ] We [00:18] looked at this budget Through the eyes of the people [00:21] who are actually paying the bills. I think for years and [00:24] years we've simply looked at a budget in terms of [00:28] the folks who are on the back end of the programs. [00:31] The recipients of the taxpayer money. But we haven't [00:33] spent nearly enough time focusing our attention On the [00:37] people who pay the taxes. [ MUSIC ] Let's give [00:59] people more choices and more control over their care. [01:04] Let's make insurance companies come in and compete [01:07] for your business. Let's return power from Washington [01:12] to the states .>> This is a budget that provides [01:15] massive tax breaks For billionaires and corporate [01:18] CEO's and massive cuts to programs that [01:23] tens of millions of struggling Americans depend upon. 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