On Monday afternoon, the Congressional Budget Office said the Republican health care bill being debated in the Senate will result in 22 million additional people losing their health insurance by 2026. The CBO is a nonpartisan institution, and its analysis could be crucial in determining whether the bill garners enough support to pass through the Senate and land on President Trump's desk.
There are several mechanisms by which the Republican legislation would result in fewer Americans having health insurance, according to the CBO. It would reduce federal subsidies for low-income Americans purchasing health care, gradually phase out funding for Obamacare's Medicaid expansion, place caps on other forms of Medicaid spending, repeal a law requiring large employers to offer health insurance to their workers, and repeal Obamacare's individual mandate.
Before the CBO report was released, five Republican Senators said that they couldn't support the Senate bill in its current form. One of them, Nevada's Dean Heller, declared that he "cannot support a piece of legislation that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans." A sixth Republican, Maine Sen. Susan Collins, said that she would wait until the CBO score came out before arriving at a final position on the bill.
If three or more Republicans vote against the legislation, and every Senate Democrat does the same, it won't have the support to pass.
The CBO projected that the bill would result in fewer low-income people having access to health care, in part because the elimination of Obamacare's cost-sharing subsidies would result in higher deductibles for plans that are otherwise affordable to them. This would be especially true for folks who fall into the "Medicaid coverage gap" — that is, Americans who make too much money to qualify for Medicaid but too little to qualify for federal subsidies.
"People with income below 100 percent of the [federal poverty line] who were not eligible for Medicaid could generally receive premium tax credits under this legislation and not under current law," the CBO report says. "However, even with the net premium of $300 shown in the illustrative examples for a person with income at 75 percent of the FPL ($11,400 in 2026), the deductible would be more than half their annual income." As a result of this, the CBO found, many low-income Americans would opt simply not to buy health insurance, as they wouldn't be able to afford the deductible.
The CBO estimates that the Senate bill would result in about one million fewer Americans losing insurance than the House version of the legislation, which passed in May but has since been changed in the Senate. Majority Leader Mitch McConnell plans to hold a final vote before the July 4th holiday.