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CBO Says Trumpcare Will Cut Care for 23 Million. Paul Ryan Calls the CBO Score a ‘Positive Step.’

The projected consequences are horrific. But Republicans were determined to look on the bright side.

Photo Illustration by Lyne Lucien/The Daily Beast

Moments after the Congressional Budget Office released their new score for the American Health Care Act, House Republicans who voted for it weeks ago—cost and consequences unseen—were determined to see the bright side of a bill that ultimately could leave 23 million people uninsured.

New Jersey Rep. Tom MacArthur, the author of the amendment that helped resurrect the bill last month, questioned the CBO methodology but still found something to like about the report. The old bill was projected to kill off health care for 24 million people in by 2026; the new one would only end coverage for 23 million people.

“The fact that a million more people are covered certainly is good and the fact that premiums are coming down more,” he said. “I think what they don’t properly account for is the fact that as premiums come down all these people they say would choose not to have insurance … I don’t think so.”

“I know people want insurance and if we can drive premiums down and offer meaningful help to people, mandate or no mandate they will buy insurance,” he said.

Speaker Paul Ryan chose to praise the bill’s deficit reduction goals in a statement, saying the CBO confirmed “the American Health Care Act achieves our mission: lowering premiums and lowering the deficit.”

“It is another positive step toward keeping our promise to repeal and replace Obamacare,” he said.  

It’s true that the new estimate released by the CBO on Wednesday afternoon did up the number of people that would be left uninsured by 2026—down from the 24 million the non-partisan scoring office estimates on an earlier version of the bill in March. And  new bill also does reduce the deficit $119 billion, dropping from $150 billion over a decade in the first version.

Rep. Mark Meadows, chairman of the House Freedom Caucus who negotiated the deal for the MacArthur Amendment, simply smiled and told Capitol Hill reporters on Wednesday evening that “there are a lot of good things about it, [and] there are some concerning areas” of the latest CBO report.

One of the “concerning areas” for the CBO was the very amendment that helped the bill squeak through the House. The MacArthur amendment allows states to opt out of essential health benefits in order to lower insurance premiums. Unfortunately, the CBO cautioned, this also could destabilize the market.

[A]bout one-sixth of the population resides in areas in which the nongroup market would start to become unstable beginning in 2020,” the report said. “That instability would result from market responses to decisions by some states to waive two provisions of federal law, as would be permitted under [the American Health Care Act].”

Still, most Republican lawmakers on the Hill knew there was precisely no chance that this CBO score would look much more attractive than the last one, which was a substantive and public-relations nightmare for Trumpcare the first time around.

When asked about the newly released report on Wednesday, Republican congressmen such as Darrell Issa and Mo Brooks silently stared back at reporters blankly.

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Others pleaded ignorance. Rep. Jason Chaffetz said he hasn’t “seen it, but I saw a headline” about the report.

Rep. Fred Upton just insisted, “I haven’t seen [the new numbers], I haven’t been online.”

Also left unsaid that for all the scrambling and hand-wringing that occured to get this version bill over the finish line, it’s still very dead in the Senate.

Earlier this month, the Trump White House and Republicans in Congress finally scored a political victory when they managed to barely pass the revised American Health Care Act through the House of Representatives. An earlier effort to get Trumpcare passed failed spectacularly in March, despite an all-out, arm-twisting campaign from the White House and President Trump himself.

The version of the AHCA that passed the House this month won over just enough hardline-conservative holdouts and more moderate skeptics—but neither camp was pleased to embrace a bill that made nobody happy, and that many saw as a political liability for the upcoming midterms.

The latest incarnation of Trumpcare does get rid of the unpopular mandate requiring people to carry insurance, but at the same time, it allows insurers to charge people who go without health insurance for two months more for their insurance.

States can apply for waivers from a range of essential health benefits—including pre-existing conditions—in order to offer lower cost plans, according to Republicans. A hastily crafted provision to the AHCA offered an additional $8 billion to help pay for high risk pools, but experts on both sides of the ideological spectrum emphasized before the bill passed the House that that figure is nowhere near enough to actually make a difference.

On top of all the hard-swallow compromise and clear imperfections, Trumpcare is now saddled with another fresh set of numbers that all-but guarantee that the House bill is destined for a gory death in the Senate.

When reporters mentioned to Republican congressman Phil Roe that the lackluster CBO numbers would further push Senate Republicans to write their own health care bill and basically throw out the House version, Roe seemed content for it to be the Senate’s burden now.

“The fact that they want to do their own bill, I understand that,” he said, adding how “hard” it was for the House Republicans to write, re-write, then squeak through their Trumpcare legislation.