CBO says health bill adds 22M to rolls of uninsured

Some senators plan to oppose GOP bill

WASHINGTON — The Senate Republican health care bill would leave 22 million more Americans uninsured in 2026 than under former President Barack Obama’s health care law, the Congressional Budget Office estimated Monday, complicating GOP leaders’ hopes of pushing the plan through the chamber this week.

Minutes after the report’s release, three GOP senators threatened to oppose a pivotal vote on the proposal this week, enough to sink it unless Senate Majority Leader Mitch McConnell, RKy., can win over some of them or other GOP critics. The Better Care Reconciliation Act will fail if just three of the 52 Republican

senators oppose it, an event that would deal a humiliating blow to President Donald Trump and Senate leaders.

Senate leaders already were working to modify their plan to overhaul the Affordable Care Act, adding a provision that would penalize consumers for not keeping their plans by imposing a six-month waiting provision before they could re-enroll.

The 22 million additional people without coverage is just a hair better than the 23 million who’d be left without insurance under the measure the House approved last month, the budget office has estimated.

In what was seen as good news for the GOP, the budget office said the Senate bill would cut the deficit by $202 billion more over the coming decade than the House version. Senate leaders could use some of those savings to attract moderate support by making Medicaid and other provisions in their measure more generous, though conservatives would prefer using that money to reduce federal deficits.

U.S. Sen. Pat Toomey, RPa., one of the drafters of the bill, cast doubt on the Congressional Budget Office’s estimates, saying they are based on “dubious assumptions, such as millions of Americans foregoing free Medicaid because they are not forced to enroll by Obamacare’s individual mandate.”

Other independent and nonpartisan experts and actuaries have different conclusions,he said late Monday.

Democrats like U.S. Rep. Mike Doyle, D-Pa., have more faith in the Congressional Budget Office. Its analysis “confirms what we all suspected,” he said. That is, that the legislation would cut taxes for the wealthy and cut health care for low-and middle-income families, including 22 million who would lose health care coverage.

Moderate Sen. Susan Collins, R-Maine, said she would vote against a GOP procedural motion, expected Wednesday, to begin formally debating the legislation. She tweeted that she favors a bipartisan effort to fix Mr. Obama’s 2010 statute but added, “CBO analysis shows Senate bill won’t do it.”

In addition, conservative Sen. Rand Paul, R-Ky., said he would oppose that motion unless the bill was changed. And fellow conservative Ron Johnson, R-Wis., said he had “a hard time believing” he’d have enough information to back that motion this week.

Those two — plus fellow conservatives Mike Lee of Utah and Ted Cruz of Texas — said last week they’d oppose the bill without changes, as did Mr. Heller.

The Senate plan, aimed at rolling back much of Mr. Obama’s 2010 statute, would end the tax penalty that law imposes on people who don’t buy insurance, in effect erasing Mr. Obama’s so-called individual mandate. It would let states ease Mr. Obama’s requirements that insurers cover certain specified services like substance abuse treatments, and eliminate taxes on wealthier people and medical companies that Mr. Obama’s law used to expand coverage.

It would also phase out extra federal money that law is providing to 31 states to expand Medicaid to additional low-income earners. And it would put annual caps on overall Medicaid money the government until now has automatically paid states, whatever the costs.

CBO said that under the bill, most insurance markets around the country would be stable before 2020. It said that similar to the House bill, average premiums around the country would be higherover the next two years — including about 20 percent higher in 2018 than under Mr. Obama’s statute — but lower beginningin 2020.