The report from the Congressional Budget Office also said federal deficits would fall by $119 billion between 2017 and 2026 under the bill, which was approved this month by the Republican-dominated House of Representatives. The CBO score raises the stakes for Republican senators now working on their own version of the legislation.
House Republicans came under sharp criticism for passing the bill before the CBO could make its assessment. The Trump administration already has relied on the House bill’s healthcare spending cuts in its proposed federal budget.
The bill is called the American Health Care Act and would fulfill a long-running Republican goal – repealing and replacing much of former President Barack Obama’s 2010 Affordable Care Act, commonly called Obamacare. President Donald Trump, who made replacing it a key campaign promise in 2016, and other Republicans say Obamacare is too costly and creates unwarranted government interference in healthcare decisions.
Congress is aiming to pass the bill under a process called reconciliation, which requires only a simple majority of votes in the Senate, where Republicans hold a 52-48 majority, instead of 60 votes. Under those rules, all elements of the bill must have a direct budgetary impact or else they must be stricken from the legislation.
A group of 13 Republican senators led by Senate Majority Leader Mitch McConnell are expected to draft their own version of the healthcare bill in the coming months. McConnell, however, told Reuters on Wednesday he does not yet know how Republicans will have the necessary votes.
The CBO said federal deficits would fall by $119 billion between 2017 and 2026 under the Republican bill.
The bill would eliminate most Obamacare taxes that help subsidize private health coverage for individuals, roll back the government’s Medicaid health plan for the poor and disabled and replace the law’s income-based tax credits for buying medical coverage with credits based on age.
The new CBO score predicts the AHCA would cover 1 million more Americans than a previous version of the bill, which the agency estimated would have left 24 million more people uninsured than Obamacare in 2026.
In the weeks leading up to the House vote on May 4, two controversial amendments were added to the bill that ultimately helped secure its passage, including one that was added the day before the vote.
One amendment would allow states to opt out of a popular Obamacare provision that prevents insurers from charging people with pre-existing conditions higher rates, as well as one that required insurers to cover 10 essential health benefits such as maternity care and prescription drugs.
Another amendment allocates an additional $8 billion over five years to help people with pre-existing conditions cover medical costs.
Trump promised to repeal Obamacare immediately upon taking office in January but replacing the program that provided health insurance to 20 million people poses political risks.
Hospitals could lose significant revenue because far fewer people will have insurance and insurers are worried about the affordability of the tax structure and proposed major changes in Medicaid financing.
The Republicans’ first attempt at undoing Obamacare resulted in a setback for the Trump agenda in March. Conservative and moderate Republican factions in the House were opposed to the initial legislation and the leadership decided not to put it up for a vote.
They found a consensus through the opt-out amendments on pre-existing conditions, which adds $8 billion for sufferers, and the essential health benefits and passed it on May 4.
Related video: Raul Labrador at the LCSC town hall (Provided by The Daily Dot)
Idaho Republican Rep. Raul Labrador sparked outrage from his audience and online after saying “nobody dies” for lack of health care access in a town hall Friday night at Lewis-Clark State College in Lewiston, Idaho.
“You are mandating people on Medicaid accept dying. You are making a mandate that will kill people,” the audience member said, before being drowned out by Labrador’s response.
“No one wants anybody to die,” Labrador said. “You know, that line is so indefensible. Nobody dies because they don’t have access to health care.”
The line immediately drew audible outrage from the crowd, as well as ire from social media users. Labrador was similarly booed for a comment he made last month that health care isn’t a “basic human right.”
Former Republican presidential candidate Mitt Romney was fiercely criticized for a similar comment he made in 2012.
“We don’t have people that become ill, who die in their apartment because they don’t have insurance,” the former Massachusetts governor told editors of the Columbus Dispatch.
It’s unclear how many people would lose health insurance under the current version of the GOP plan, which has yet to be scored by the Congressional Budget Office.
Democrats mocked Republicans from the House floor Thursday after GOP representatives voted to pass the American Health Care Act by chanting “na-na-na-na, na-na-na-na, hey, hey, hey, goodbye,” at their counterparts.
The chant appeared to be in reference to Democrats’ belief that a vote for the AHCA, the Republican proposal to repeal and replace the Affordable Care Act, would result in many of the Republican representatives being voted out of office next year.
The bill passed by a slim 217-to-213 margin. It now will advance onto the Senate, where it could be subjected to alterations and its fate is unclear.
The first iteration of the bill was pulled from the House floor in March after it became apparent it would not have enough votes to pass. This version featured a couple of tweaks, which helped push it over the finish line.
In a speech preceding the vote, House Minority Leader Nancy Pelosi said a vote for the AHCA would be tattooed on those members of Congress’ faces, and they would “glow in the dark” from the vote.
House Republicans departed Congress soon after the vote to travel to the White House for a Rose Garden celebration and press conference with President Donald Trump.
The vote on the American Health Care Act, originally scheduled Thursday but then pushed to Friday after failing to gain conservative support, was canceled after it appeared that Republicans had failed to get enough support from within their own party for it to pass. House Speaker Paul Ryan admitted Friday that the GOP “came up short.”
Mr. Trump and Ryan already pushed to blaming Democrats, with Mr. Trump saying “we had no Democrat support” and Ryan saying that “moving from opposition party to a governing party comes with growing pains.”
“I think the losers are Nancy Pelosi and Chuck Schumer because now they own Obamacare,” Mr. Trump said. “They own it. Hundred percent own it. And this is not a Republican healthcare, this is not anything but a Democrat healthcare and they have Obamacare for a little while longer until it ceases to exist, which it will at some point in the near future.”
Ryan said that Obamacare will “remain the law of the land” until it is replaced.
Mr. Trump insisted that he never said “repeal and replace within 64 days” on the campaign trail.
“I’ve been saying for the last year and a half that the best thing we can do politically speaking is let Obamacare explode,” Mr. Trump said. “It is exploding right now.”
Mr. Trump said that in this scenario, perhaps then there will bipartisan support for a “truly great health care bill.”
President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid.
Trump declined to reveal specifics in the telephone interview late Saturday with The Washington Post, but any proposals from the incoming president would almost certainly dominate the Republican effort to overhaul federal health policy as he prepares to work with his party’s congressional majorities.
Trump’s plan is likely to face questions from the right, following years of GOP opposition to further expansion of government involvement in the health-care system, and from those on the left, who see his ideas as disruptive to changes brought by the Affordable Care Act that have extended coverage to tens of millions of Americans.
In addition to his replacement plan for the ACA, also known as Obamacare, Trump said he will target pharmaceutical companies over drug prices and demand that they negotiate directly with Medicaid and Medicare.
“They’re politically protected but not anymore,” he said of pharmaceutical companies.
The objectives of broadening access to insurance and lowering health-care costs have always been in conflict, and it remains unclear how the plan that the incoming administration is designing — or ones that will emerge on Capitol Hill — will address that tension.
In general, congressional GOP plans to replace Obamacare have tended to try to constrain costs by reducing government requirements, such as the medical services that must be provided under health plans sold through the law’s marketplaces and through state’s Medicaid programs. House Speaker Paul D. Ryan (R-Wis.) and other Republicans have been talking lately about providing “universal access” to health insurance, instead of universal insurance coverage.
Trump said he expects Republicans in Congress to move quickly and in unison in the coming weeks on other priorities as well, including enacting sweeping tax cuts and beginning the building of a wall along the U.S.-Mexico border.
Trump warned Republicans that if the party splinters or slows his agenda, he is ready to use the power of the presidency — and Twitter — to usher his legislation to passage.
“The Congress can’t get cold feet because the people will not let that happen,” Trump said during the interview with The Post.
Trump said his plan for replacing most aspects of Obama’s health-care law is all but finished. Although he was coy about its details — “lower numbers, much lower deductibles” — he said he is ready to unveil it alongside Ryan and Senate Majority Leader Mitch McConnell (R-Ky.).
“It’s very much formulated down to the final strokes. We haven’t put it in quite yet but we’re going to be doing it soon,” Trump said. He noted that he is waiting for his nominee for secretary of health and human services, Rep. Tom Price (R-Ga.), to be confirmed. That confirmation rests with the Senate Finance Committee, which has not yet scheduled a hearing.
Trump’s declaration that his replacement plan is ready comes after many Republicans — moderates and conservatives — expressed anxiety last week about the party’s lack of a formal proposal as they held votes on repealing the law.
Once made public, Trump said he is confident his plan could get enough votes to pass in both chambers but he declined to discuss how he would court wary Democrats.
So far, Republicans have used budget reconciliation — where only a majority is needed — on the initial steps to repeal the health law. Removing or replacing other parts of the law will likely require 60 votes to overcome Democratic filibusters. Republicans control the Senate 52 to 48.
“I think we will get approval. I won’t tell you how, but we will get approval. You see what’s happened in the House in recent weeks,” Trump said, referencing his tweet during a House Republican move to gut their independent ethics office, which along with widespread constituent outrage was cited by some members as a reason the gambit failed.
As he has developed a replacement package, Trump said he has paid attention to critics who say that repealing Obamacare would put coverage at risk for more than 20 million Americans covered under the law’s insurance exchanges and Medicaid expansion.
“We’re going to have insurance for everybody,” Trump said. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”
People covered under the law “can expect to have great health care. It will be in a much simplified form. Much less expensive and much better.”
For conservative Republicans dubious about his pledge to ensure coverage for millions, Trump pointed to several interviews he did during the campaign where he promised to “not have people dying on the street.”
“It’s not going to be their plan,” he said of people covered under the current law. “It’ll be another plan. But they’ll be beautifully covered. I don’t want single-payer. What I do want is to be able to take care of people,” he said Saturday.
Trump did not say how his program overlaps with the comprehensive plan authored by House Republicans. Earlier this year, Price suggested that a Trump presidency would advance the House GOP’s health-care agenda.
When asked in the interview whether he intends to cut benefits for Medicare as part of his plan, Trump said “no,” a position that was reiterated Sunday on ABC by Reince Priebus, Trump’s incoming chief of staff. He did not elaborate on that view or how it would affect his proposal. He expressed that view throughout the campaign.
Timing could be difficult as Trump puts an emphasis on speed. Obama’s law took more than 14 months of debate and hundreds of hearings. To urge the Congress on, Trump will attend a congressional Republican retreat in Philadelphia later this month.
Moving ahead, Trump said lowering drug prices is central to lowering health costs nationally — and will make it a priority for him as he uses his bully pulpit to shape policy.
When asked how exactly he would force drug manufacturers to comply, Trump said part of his approach would be public pressure “just like on the airplane,” a nod to his tweets about Lockheed Martin’s F-35 fighter jet, which Trump said was too costly.
Trump waved away the suggestion that such activity could lead to market volatility. “Stock drops and America goes up,” he said. “I don’t care. I want to do it right or not at all.”He added that drug companies “should produce” more products in the United States.
On his plan for new tax cuts, Trump said “We’re getting very close” to putting together legislation. His advisers and Ryan met last week and have been working from his campaign’s plan and from congressional proposals to slash current rates.
“It’ll probably be 15 to 20 percent for corporations. For individuals, probably lower. Great middle-class tax cuts,” Trump said.
On corporate tax rates, “We may negotiate a little, but we want to bring them down and get as close to 15 percent as we can so we can see a mushrooming of jobs moving back.”
Trump said he would not relent on his push for increasing taxes on U.S. companies that manufacture abroad — and insisted that the upcoming tax cuts should be enough reason for companies to produce within the United States.
“If companies think they’re going to make their cars or other products overseas and sell them back into the United States, they’re going to pay a 35 percent tax,” he said.
Briefly touching on immigration, Trump said that building a border wall and curbing illegal immigration remains at the top of his to-do list and he is spending significant time looking at ways to begin various projects, both with Congress and through executive action. But he did not disclose what was to come on those fronts.