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Number of uninsured Americans would jump if health reform were repealed

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If the 2010 health care reform law were repealed, the nation's uninsured rate would skyrocket, according to a report released Monday.

The uninsured rate would leap to 19.4% by 2021, a whopping 81% increase compared with the projected 10.7% uninsured rate in 2021 if the Patient Protection and Affordable Care Act stays in place, according to the analysis by the Washington-based Urban Institute.

In all, 53.5 million Americans would be uninsured compared with 29.6 million if the law remains, according to the report.

“Repealing the ACA would first and foremost deprive 20 million people of their health insurance, thereby nearly doubling the size of the uninsured population,” Kathy Hempstead, senior adviser for health care for the Princeton, New Jersey-based Robert Wood Johnson Foundation, which helped fund the study, said in a statement.

The biggest drop in coverage would be within the nation's lower-income population. For example, enrollment in the Medicaid program would fall to 54.8 million in 2021, down from a projected 69.3 million, the study said.

That drop would be the result of the end of an ACA provision in which the federal government heavily subsidizes states that expand Medicaid eligibility to those earning up to 138% of the federal poverty level, up from the prior 100% of the federal poverty level limit. About 30 states have accepted the federal subsidies.

In addition, 11.5 million people would have nongroup health coverage in 2021, 8.8 million fewer people than the projected 20.3 million with such coverage if the ACA were not repealed. That big reduction would be triggered by the loss of rich federal ACA premium subsidies available for the lower-income uninsured — those with incomes between 100% and 400% of the federal level — to purchase coverage in public health insurance exchanges.

Earlier this year, Congress, voted on legislation that would have gutted the ACA. President Barack Obama vetoed the measure, and repeal backers were unable to come up with enough votes to overturn the presidential veto.

Donald Trump, the presumptive Republican presidential candidate, backs ACA repeal, while Hillary Clinton, the presumptive Democratic candidate, supports the law, with a few modest changes.

Another Democratic candidate, Sen. Bernie Sanders, I-Vt., would dismantle the law in favor of a single-payer system.