Unfortunately for Senate Republicans, those are three things that, politically, make it difficult for them to sell the bill back home — and it could derail the entire process.
The CBO estimated that 49 million people would be uninsured by 2026 under the Senate Republicans’ health-care plan. That not only reverses all the coverage gains made under the Affordable Care Act, but it also leaves more people uninsured than at the height of the recession.
The coverage loss largely comes from the changes the bill makes to Medicaid. It rolls back the expansion and caps the amount of money being put into the program, for a total of $772 billion in cuts to the program.
But the losses within the individual marketplace are significant, too.
Premiums would be expected to skyrocket for the elderly, nearly quadrupling for those with income of about $26,500 per year and pricing many people out of the market.
Premiums are expected to drop, on average, for younger people, because some sicker people would not be able to get insurance at all, which makes the health-insurance market cheaper for healthy people.
For those who could afford to get covered, their insurance would be less comprehensive. The CBO expects the federal government will cover 70 percent of someone’s health-care costs, on average, compared with 87 percent under Obamacare and 65 percent under an early version of House Republicans' health-care bill. In 2020, when the federal government cuts off cost-sharing subsidies for low-income people, the value of their health insurance plans will fall even further.
But the CBO score does have one strong selling point for Republicans. Like the House bill, it meaningfully reduces the deficit. It would provide $321 billion in savings over 10 years, compared with the House bill’s $119 billion. It does that, though, by cutting Medicaid and leaving millions more uninsured.
At this point, it’s unclear whether the Senate GOP’s bill will pass. Republicans will need almost all of their members to support it, but multiple senators have already expressed concern or outright opposition. A vote is expected Thursday, and if the Senate bill passes, it will have to be reconciled with the House’s more conservative bill before heading to President Trump’s desk.
Kevin Uhrmacher contributed to this report.