Donald Trump's recently released plan to repeal the Affordable Care Act would drive up the federal deficit by nearly $500 billion over the next decade and cause 21 million Americans to lose health coverage, according to a new independent analysis.
Trump's "Healthcare Reform to Make America Great Again" plan, which the GOP presidential front-runner outlined on his campaign website last month, does not include much detail.
But its major planks – including repealing Obamacare, deregulating health insurance and offering tax breaks to help Americans get coverage – would likely have a devastating effect, the new analysis from the Committee for a Responsible Federal Budget concludes.
"Mr. Trump's plan to repeal and replace Obamacare – based on the details available – would both add to the deficit and significantly reduce coverage," the report notes.
The Committee for a Responsible Federal Budget, a Washington-based fiscal watchdog, is often critical of politicians of both parties.
It earlier took to task Sen. Bernie Sanders (I-Vt.) for his campaign pledge to create a single government health plan for all Americans, finding Sanders' numbers unrealistic.
Trump's plans have been difficult to assess because until recently he made only broad promises to come up with a "terrific" replacement for the health law President Obama signed in 2010.
Beyond repeal, his current plan relies largely on bedrock conservative health proposals, including allowing insurers to sell their health plans anywhere in America, thereby avoiding state regulators.
He has also proposed to free states from much federal oversight of their Medicaid safety net health plans, a plan that Republicans have often tried to advance as a way to empower states while dramatically cutting federal spending.
The new report notes that without more detail about how Trump would structure so-called Medicaid block grants, it is difficult to assess what effect his plans would have.
But the overall effect of scrapping the 2010 health law is likely to be enormous, largely because that would eliminate new subsidized insurance marketplaces and federal aid that has allowed 30 states to expand eligibility for their Medicaid programs.
Thanks largely to these pillars of the health law, some 20 million previously uninsured Americans have gained coverage in recent years.
Nearly all of these people would lose their health care protections under Trump's plan, according to the report.
Repealing the current law would also eliminate major funding sources, including new taxes and savings in Medicare achieved by curtailing payments to hospitals, doctors and other providers. That would drive up the deficit.
The report notes that the fiscal effect of Trump's plan might be less if potential economic growth linked to repeal is included. But even then, the deficit would balloon by some $270 billion over the next decade, the report concludes.
The Trump campaign did not respond to a request for comment.
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