The CBO generally performs careful, in depth analyses – but their approach is susceptible to inaccuracy when policy proposals differ sharply from existing norms. The CBO projects that over 24m individuals will lose insurance coverage as a result of the AHCA, as older individuals leave the insurance market faster than younger individuals join it. This projection misses the power of free plans, however. The table below shows how much different age groups might pay for coverage under the ACHA, with prices based on 2017 ACA exchange prices for states with low (Oregon), medium (Ohio), and high (Nebraska) insurance costs [1]. As the table shows, the AHCA is generous enough to provide potentially free plans to the majority of Americans below age 45.
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| Cost after AHCA Tax Credit (Plan cost as found on healthcare.gov, cheapest available plan) |
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| State | Age 20 | Age 30 | Age 40 | Age 50 | Age 60 | Family Ages 40,10,8 | Family Ages 30,30,5,3 |
| Oregon (Low Cost State, Zip 97035 Used) | Free ($112) | Free ($208) | Free ($234) | $35 ($327) | $160 ($493) | Free ($466) |
Free ($648) |
| Ohio (Medium Cost State, Zip 43004 Used) | Free ($121) | $12 ($216) | Free ($244) | $49 ($341) | $186 ($519) | Free ($487) |
Free ($677) |
| Nebraska (High Cost State, Zip 68010 Used) | Free ($131) | $66 ($274) | $59 ($309) | $139 ($431) | $323 ($656) | $33 ($616) | $105 ($855) |
Using the information compiled above, we can estimate the change in uninsured rates for each of the groups in the chart below. For age groups below 40, the uninsured rate is projected to drop to the same level as that of children below 19, since these groups will have access to free plans paid for by tax credits (insurance companies will market these free plans mercilessly). For age groups above 45, the uninsured rate will Rise, though not quite to pre-ACA levels when no support was provided.
The CBO estimates that 14 million Americans will lose Medicaid coverage, and that 9 million more will lose either individual or employer-based coverage.
Using population estimates for 2026, I calculate that the number of insured Americans aged 19-34 rises by 7 million, aged 35-44 rises by roughly 2 million, and aged 45-64 drops by roughly 2 million [2]. While it’s important to note that these plans will be much less generous than ACA-subsidized plans, the total number of insured actually rises by around 7 million under these estimates. The GOP will have installed universal, nearly-free catastrophic plans as the future of American health care – if the AHCA passes, as Mssrs. Trump and Ryan continue their struggle to get it passed.
P.S. If you are interested to find out more about how the AHCA might impact you or your clients’ investments, my company HiddenLevers has modeled that in our TrumpCare scenarios. Have a look through one of our free demo accounts.
[1] The 2017 ACA prices are a reasonable guide as the Trump administration plans to relax the essential benefits associated with plans, and to widen the max price differential between plans for young and old.
[2] Roughly 23% of the population is aged 19-34, and a 9% point drop in uninsured rate for this group in 2026, translates to a rise of 7m more insured Americans. A similar calculation for the 35-44 group yields another 2m insured Americans, while the 2.5% rise in uninsured among older Americans yields a loss of insurance for 2 million.
[3] The original chart above can be found here at the CommonWealth Fund.
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