Leading House Republicans are fighting to defend their ObamaCare replacement bill in the face of a Congressional Budget Office (CBO) report that found the measure would result in millions of people becoming uninsured.
Democrats are on the attack, hoping the findings — and the eye-popping estimate that 24 million additional people will be without coverage by 2026 — will stop ObamaCare repeal in its tracks.
“Numbers are quite eloquent things; they speak very clearly,” said House Democratic Leader Nancy Pelosi (D-Calif.) Monday evening after the CBO’s report was released.
“I would hope that they would pull the bill,” she added. “It’s really the only decent thing they could do.”
Republicans had long expected that the CBO score would produce uncomfortable headlines that could sap support.
The task ahead, for Speaker Paul Ryan (R-Wis.) and his lieutenants, is to weather the storm.
Ryan went on Fox News soon after the report was released and said he was “encouraged” by the findings. He pointed to items like the deficit reduction and decrease in premiums that the report found, while seeking to downplay the coverage losses.
Much of the change in the uninsured rate, Ryan said, would simply be due to people choosing not to buy coverage once the mandate for having coverage is repealed.
“What I’m encouraged [by] is, once our reforms kick in, what the CBO is telling us is, it’s going to lower premiums — it will lower premiums 10 percent. It stabilizes the market. It’s a $1.2 trillion spending cut, an $883 billion tax cut, and $337 billion in deficit reduction,” Ryan said.
“So of course the CBO is going to say if you’re not going to force people to buy something they don’t want to buy, they won’t buy it.“
CBO did find that some of the reduction in coverage would be from people choosing not to buy coverage because of the repeal of the individual mandate under ObamaCare. But the report also found that many people would go without coverage because of cuts to Medicaid and because they would receive less financial assistance to buy insurance.
The White House, which sought to discredit the CBO even before the report was released, took a different approach than Ryan, questioning the report’s accuracy.
“We disagree strenuously with the report that was put out,” Tom Price, President Trump’s Health and Human Services secretary, said at a press conference late Monday at the White House.
Price disputed the CBO’s finding that the legislation would result in an additional 14 million people going without insurance next year, calling that “virtually impossible.”
“It’s just not believable, is what we would suggest,” he said.
While the CBO’s findings are creating difficulties for the GOP, the report also provided some ammunition for Ryan as he tries to sell the bill to skeptical conservatives.
For one, the scorekeeper found that the bill would reduce the deficit by more than $300 billion over a decade — a significant number that could appeal to fiscal hawks concerned about rising red ink. The bill also found that healthcare premiums would fall, though partly due to older people going without coverage.
But CBO score did little, however, to address the principal objections of conservatives: namely, that the bill doesn’t fully repeal ObamaCare and that it will create a new entitlement program.
Rep. Mark Walker (R-N.C.), chairman of the conservative Republican Study Committee, said in a statement that the score “does little to alleviate our conservative concerns for this ObamaCare replacement bill.”
Walker pointed to the size of the tax credits, skepticism that Congress would actually allow future Medicaid cuts to happen, and doubts that abortion restrictions could survive Senate rules.
Opposition from seniors — a key base of support for the GOP — could also be politically damaging for the legislation.
The AARP called the bill “harmful” Monday night and added: “Putting the financial burden on older Americans is not the way to solve the problems in our health care system.”
While premiums would fall 10 percent overall by 2026, CBO found, they would increase by an average of 20 to 25 percent for a 64 year-old. Premiums after financial assistance for a 64 year-old making $26,500 would increase from $1,700 to a whopping $14,600 under the GOP bill, the report said.
Many Senate Republicans were already voicing skepticism of the House bill before the CBO score was released. They are urging their colleagues to slow down on the legislation.
Sen. Bill Cassidy (R-La.) called the score “awful.”
Sen. Susan Collins (R-Maine) said it “should prompt the House to slow down and reconsider certain provisions of the bill.”
Added Sen. Lindsey Graham (R-S.C.): “If half of the CBO is true I think we should slow down.”
Trump himself has expressed doubts about the political wisdom of pressing ahead, repeating his frequent musing again Monday that it would be easier to just let ObamaCare fall under its own weight.
“The best thing you could do politically is wait a year, cause it’s going to blow itself off the map,” Trump said. “But that’s the wrong thing to do for our country. It’s the wrong thing to do for our citizens.”
But House Republican leaders are pressing ahead.
The House Budget Committee is set to hold a final markup of the legislation on Thursday, setting the stage for a floor vote next week that could turn into a cliffhanger.
“This week, a third House committee will debate the American Health Care Act as part of an open, transparent process,” Ryan said in a statement.
“We have set out a clear goal — to give every American access to quality, affordable care — and a clear plan to achieve it. Now we must keep our promise and deliver.”