A Republican plan to repeal and replace former President Barack Obama's signature health care law will result in 23 million more Americans without insurance than current numbers, the nonpartisan Congressional Budget Office (CBO) said Wednesday.
More than half of that increase in the uninsured - 14 million - would come from reduced Medicaid enrollment.
Even before the report, many Republican senators were wary of the House version of the healthcare bill, saying it unraveled Obamacare too much and too quickly. It is now headed to the Republican-held Senate where its future remains uncertain.
The score is already roiling the debate in the Senate, however, where some Republicans say the House template is too draconian.
The Congressional Budget Office and Joint Committee on Taxation estimate that the bill would reduce the cumulative federal deficit over the 2017-2026 period by $119 billion.
As bad as all that sounds, leaders in the House are breathing a sigh of relief because there was a chance, based on the CBO's findings, that the bill would have to be re-worked and put to a second vote - a vote it was unclear the bill would survive - before it could be sent to the Senate.
The CBO's analysis comes as a Senate group is working on their own healthcare bill that is believed to differ drastically from the House version, especially when it comes to Medicaid provisions.
"Over time, it would become more hard for less healthy people (including people with preexisting medical conditions) in those states to purchase insurance because their premiums would continue to increase rapidly", the CBO wrote.
The CBO also estimated that in states deciding to take the option to waive requirements related to charging sicker people more, "the nongroup market would start to become unstable". In addition to increasing the number of uninsured broadly, Trumpcare would disproportionately increase the number of uninsured among older people - particularly people between 50 and 64 years old.
Senate Majority Leader Mitch McConnell, R-Ky., who did not issue a statement in response to the new budget score, suggested in an interview with Reuters that he still harbored doubts over whether his party could muster enough votes to pass any kind of health-care bill this year. "Those markets would no longer fulfill one of their fundamental purposes, which is ensuring that people can get health care when they need it", he said.
"I just have to point out that makes us as House members who resisted the expansion look awfully stinking smart", he said. I think their report is very similar to previous ones except in one key way: The CBO really pushes back aggressively against some of the claims that Republicans have made about their plan. Because of those policies' skimpy coverage, the CBO doesn't count those people as insured in this report.
Cassidy, who is also a physician, previously cited late night host Jimmy Kimmel's emotional monologue about health care to use as a measuring stick on a GOP bill. It did not guess which states might do that, but the report says that one-sixth of the population could be subject to that instability.
Many people in states that under the bill could permit slimmer benefits and higher premiums for customers with pre-existing conditions "would face substantial increases in their out-of-pocket costs", the report said.
While AHCA has some language that is meant to protect those with pre-existing conditions, health care experts have previously told us that the legislation would allow insurance companies to charge more for people with pre-existing conditions.
Republicans argue that by allowing insurers to sell less comprehensive insurance, premiums will fall and more people will buy basic coverage. Missing the bill's current target of at least $2 billion in savings over 10 years could have derailed the measure and may have required a second House vote. I have never seen a health care bill which throws 23 million Americans off of health insurance.