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Trump's pledge to cut health-care costs won't come cheap

Though short on details, President Donald Trump redoubled his commitment Tuesday night to "repeal and replace" the Affordable Care Act.

In a speech to a joint session of Congress, Trump vowed to "decisively to protect all Americans." from a "broken" health-care system.

"The way to make health insurance available to everyone is to lower the cost of health insurance," Trump said to sustained applause. "And that is what we are going to do."

Congressional Republicans are eagerly anticipating their long-awaited chance to repeal the 6-year-old Affordable Care Act, one of the signature achievements of the Obama administration.

That enthusiasm may be dampened, though, as they hammer out the details of a replacement that lowers health costs for American households.

For starters, repealing Obamacare will cost the federal government as much as $350 billion, according to a recent analysis by the nonpartisan Committee for a Responsible Budget.

Most of the law's opponents have focused on the added cost of subsidizing health insurance. But the law also includes dozens of provisions that cut health care and raise taxes that more than offset the money spent.

Despite the GOP's steadfast opposition to the law, that net cost of repealing it could give pause to the party's fiscal hawks on Capitol Hill.

The new analysis looks only at the net cost to the federal government and doesn't take into account the far bigger economic impact on insurers, hospitals, doctors, drug companies and other parts of the sprawling American health system. Nor does its estimate include the financial impact on the roughly 23 million Americans who, the group estimates, would lose coverage if the ACA is fully repealed and not replaced.

After more than 60 failed votes to gut the ACA under President Barack Obama, Republicans in control of the White House and Congress are poised to eliminate the law that extended health insurance to millions of American families. Trump and congressional Republicans have vowed to move quickly to repeal the law before articulating the complicated details of a potential replacement.

Until details are worked out, though, it's impossible to estimate the financial impact of any replacement plan on the government, the health system and those currently covered by Obamacare.

In its analysis of the cost of repeal, the Committee for a Responsible Budget said the $350 billion price tag could be reduced by indirect economic benefits that would cut the long-term impact to $150 billion over 10 years.

"Repealing the entire ACA would leave no funds available for 'replace' legislation, and in fact would require further deficit reduction to avoid adding to the debt," the report said.