Center on Budget & Policy Priorities- The House bill to repeal the Affordable Care Act wouldn’t just cause 24 million people to become uninsured, as the Congressional Budget Office reports; it also would weaken Medicare by repealing a payroll tax on high earners that supports Medicare’s Hospital Insurance trust fund and by increasing Medicare spending for the uninsured.
The ACA imposed an additional payroll tax of 0.9 percent on earnings above $200,000 for an individual and $250,000 for a couple, bringing the total payroll tax to 3.8 percent on earnings above those levels. Repealing the payroll tax add-on would reduce federal revenues by $117 billion over the 2017-2026 period, according to the Joint Committee on Taxation. This would undermine Medicare’s financing while providing a windfall to high earners.
It also would be highly regressive. Nearly two-thirds of the benefits would go to millionaires, who would get tax cuts of $13,700 each, on average, in 2025, according to the Tax Policy Center. At the same time, the House bill would undermine the financial security of millions of low- and moderate-income households by repealing the ACA’s coverage expansions and raising the cost of buying coverage and paying out-of-pocket expenses.