An estimated 23 million Americans will lose health insurance over a 10-year period under the Republican health care bill aimed at repealing the Affordable Care Act, the non-partisan Congressional Budget Office says.
The CBO released its analysis of the House-passed bill on Wednesday, giving the public an estimate of the impact the measure would have on health coverage, premiums and the nation's budget. It says more consumers would have pared down coverage and many more would face higher deductibles under the bill, which was narrowly approved 217-213 on May 4.
Replacing the Affordable Care Act, commonly known as Obamacare, was a priority of Donald Trump during his presidential campaign, and of Republican lawmakers since its enactment in 2010.
The CBO issued two reports on earlier versions of the Republican legislation, the American Health Care Act, in March. Both concluded the bill would increase the number of uninsured Americans by 24 million over a period of 10 years.
The reports also projected the bill would increase premiums by an average of 15- to 20 percent over a two-year period, but push them 10 percent lower than they would otherwise be by 2026.
A narrow win for Republicans
The reports prompted some conservative and moderate Republican lawmakers to abandon their support for the measure and craft new language for a revised bill that managed enough votes to narrowly win House approval.
The new provisions would allow states to permit insurance companies to increase premiums on some people with pre-existing conditions and waive the federal "essential health benefits" requirement. States would also get permission to allow insurers to charge higher premiums for older people.
Democratic lawmakers have attacked the changes, maintaining they are designed to victimize people with serious health problems that require expensive medical care.
The latest bill would cut taxes by about $1 trillion over a decade, mostly on higher income people and health insurers, the CBO said. It would replace Obama's tax subsidies for health insurance consumers with tax credits based largely on age instead of income.
Most people who would lose coverage would be beneficiaries of Medicaid, the federal health care program for poor and disabled people. The last CBO report estimated the House bill would cut Medicaid by nearly $840 billion over a decade.
Budget decisions based on pragmatism.
Office of Management and Budget Director Mick Mulvaney told members of the House Budget Committee Wednesday that Republicans do have compassion toward poor people, but their budget decisions are based on pragmatism.
"We look at it from different perspectives, which is the balance: Those who receive the benefits and the folks who pay for the benefits," Mulvaney said.
Once the House approves a health care bill, the measure would then go to the 100-member Senate, where it currently does not have the support of the majority — according to the Senate's top Republican.
"I don't know how we get to 50 (votes) at the moment, but that's the goal," Senate Republican Leader Mitch McConnell told Reuters Wednesday in an exclusive interview.
McConnell declined to provide a timetable for when a draft of a Senate bill would be available for members to review.