CONGRESS: 14 million lose coverage under GOP health care bill

The White House says it disagrees "strenuously" with a budget analysis of the Republican health care plan.

Health Secretary Tom Price says it will cover more individuals and lower costs.

Congress' nonpartisan budget analysts projected Monday that 14 million Americans would lose coverage next year under House Republican legislation remaking the nation's health care system. The Congressional Budget says that figure would grow to 24 million by 2026.

But Price says the administration disagrees "strenuously with the report that was put out."

Price complained the CBO only looked at the House bill, and not the two other parts of their three-phase plan.

As for the estimate that 14 million people would lose coverage, he says, "It's just not believable is what we would suggest."

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Fourteen million Americans would lose coverage next year under House Republican legislation remaking the nation's health care system, and that figure would grow to 24 million by 2026, Congress' nonpartisan budget analysts projected Monday. The figures dealt a blow to a GOP drive already under fire from both parties and large segments of the medical industry.

The report by the Congressional Budget Office flies in the face of President Donald Trump's aim of "insurance for everybody," and he has been assailing the credibility of the CBO in advance of the release. Administration officials quickly took strong issue with it.

It also undercuts a central argument that he and other Republicans have cited for swiftly rolling back former President Barack Obama's health care overhaul: that the health insurance markets created under the 2010 law are unstable and about to implode. The congressional experts said that largely would not be the case and the market for individual health insurance policies "would probably be stable in most areas either under current law or the (GOP) legislation."

Even though Republican tax credits would be less generous than those under "Obamacare," the combination of those credits and other changes to lower premiums would attract enough healthy people to stabilize markets under the new plan, the report said.

In a talking point embraced by Republicans, the budget office concluded that the GOP measure would reduce federal deficits by $337 billion over the coming decade. That's largely because the legislation would cut Medicaid and eliminate subsidies Obama's law provides millions of people who buy coverage.

The budget office attributed the projected increases in uninsured Americans to the GOP bill's elimination of tax penalties for people who don't buy insurance, its changes in federal subsidies for people who buy policies and its curbing of Medicaid, the federal-state program that helps low-income people buy coverage.

By 2026, the office estimated, a total of 52 million people would lack insurance — including 28 million already expected to lack coverage under Obama's statute.

While long anticipated, the budget office's adverse estimates provide a detailed, credible appraisal of the Republican effort by an agency with a four-decade history of even-handedness that's currently headed by a GOP appointee. It feeds ammunition to Democrats and to some Republicans who've argued the GOP measure would toss millions of voters off coverage they gained under Obama's overhaul.

Trump said in an address to Congress last month that he wants to "expand choice, increase access, lower costs and at the same time provide better health care," a less expansive coverage goal that has been embraced by House Speaker Paul Ryan, R-Wis., and other authors of the GOP legislation.

Backed by Trump, House Republican leaders say coverage statistics are misleading because rising out-of-pocket costs make the policies many gained under Obama's statute unaffordable.

The budget office found that average premiums for individuals would rise in 2018 and 2019 by 15 percent to 20 percent compared to current law, because Republicans would eliminate the penalties designed to induce people to buy insurance coverage.

But beginning in 2020, premiums would begin to fall in comparison to current law, and by 2026 average premiums for people buying individual coverage would be roughly 10 percent lower than current law.

However, premiums would vary significantly for people of different ages because of a change Republicans would make allowing old people to be charged more for insurance coverage, compared to young people, than allowed under Obamacare.

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Republicans pushing a plan to dismantle Barack Obama's health care law are bracing for a Congressional Budget Office analysis widely expected to conclude that fewer Americans will have health coverage under the proposal, despite President Donald Trump's promise of "insurance for everybody."

House Speaker Paul Ryan said he fully expects the CBO analysis, set to be released as early as Monday, to find less coverage since the GOP plan eliminates the government requirement to be insured.

But Ryan and Trump administration officials vowed to move forward on their proposed "repeal and replace" plan, insisting they can work past GOP disagreements and casting the issue as one of "choice" in which consumers are freed of a government mandate to buy insurance.

"What we're trying to achieve here is bringing down the cost of care, bringing down the cost of insurance not through government mandates and monopolies but by having more choice and competition," Ryan, R-Wis., said on Sunday. "We're not going to make an American do what they don't want to do."

The CBO's long-awaited cost analysis of the House GOP leadership plan, including estimates on the number of people expected to be covered, will likely affect Republicans' chances of passing the proposal.

GOP opponents from the right and center are already hardening their positions against the Trump-backed legislation. House conservatives vowed to block the bill as "Obamacare Lite" unless there are more restrictions, even as a Republican, Sen. Tom Cotton, R-Ark., warned the plan would never pass as is due to opposition from moderates.

"Do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote," Cotton said. "If they vote for this bill, they're going to put the House majority at risk next year."

Trump was bullish about Republican chances of passing a health care bill, tweeting Monday, "Republicans will come together and save the day."

"ObamaCare is imploding. It is a disaster and 2017 will be the worst year yet, by far!" he tweeted.

The GOP legislation would eliminate the current mandate that nearly all people in the United States carry insurance or face fines. It would use tax credits to help consumers buy health coverage, expand health savings accounts, phase out an expansion of Medicaid and cap that program for the future, end some requirements for health plans under Obama's law, and scrap a number of taxes.

During the presidential campaign and as recently as January, Trump repeatedly stressed his support for universal health coverage, saying his plan to replace the Affordable Care Act would provide "insurance for everybody."

On Sunday, his aides took pains to explain that a CBO finding of fewer people covered would not necessarily mean that fewer people will be covered.

"If the CBO was right about Obamacare to begin with, there'd be 8 million more people on Obamacare today than there actually are," said Mick Mulvaney, director of the White House Office of Management and Budget, disputing the accuracy of CBO data. "Sometimes we ask them to do stuff they're not capable of doing, and estimating the impact of a bill of this size probably isn't the best use of their time."

Health Secretary Tom Price said he "firmly" believed that "nobody will be worse off financially" under the Republicans' health care overhaul. He said people will have choices as they select the kind of coverage they want as opposed to what the government forces them to buy. In actuality, tax credits in Republican legislation being debated in the House may not be as generous to older people as what is in the current law.

Gary Cohn, Trump's chief economic adviser, described past CBO analyses as "meaningless."

"We are offering coverage to everyone," he said. "If you are on Medicaid today, you're going to stay on Medicaid. If you are covered under an employee-sponsored plan, you're going to be continued to be covered under an employee-sponsored plan. If you fall into that middle group, we're going to provide tax credit so you can go out and buy a plan."

House conservatives weren't buying it.

Rep. Jim Jordan, R-Ohio, a co-founder of the House Freedom Caucus, criticized the plan as an unacceptable form of "Obamacare Lite." He and other caucus members want a quicker phase-out of Medicaid benefits and are opposed to proposed refundable tax credits as a new entitlement that will add to government costs.

Members of the caucus will meet with White House officials on Tuesday. They expressed hope that Trump is sincere in expressing a willingness to negotiate changes, criticizing Ryan for his "take it or leave it" stance.

"I'm not for this plan and I think there's lot of opposition to this plan in the House and Senate," Jordan said. "Either work with us or you don't end up getting the votes. That's the real choice here."

But pressuring the White House on the opposite side were moderate Republican governors and senators, who said Trump needed to allow for continuing Medicaid coverage for the poor.

"It's not like we love Obamacare. It means don't throw the baby out with the bathwater," said Ohio Gov. John Kasich, a Republican. "Don't kill Medicaid expansion. And you've got to fix the exchange, but you have to have an ability to subsidize people at lower income levels."

"We need to have Democrats involved so that what we do is going to be not only significant but will last," Kasich added.

Ryan spoke on CBS' "Face the Nation," Price and Kasich appeared on NBC's "Meet the Press," Mulvaney spoke on ABC's "This Week" and CNN's "State of the Union," Cotton was on ABC's "This Week," and Jordan and Cohn appeared on "Fox News Sunday."