(Bloomberg) — A new estimate showing that 14 million Americans could lose health coverage by next year under the GOP Affordable Care Act de-funding plan leaves House Republicans in a bind with its dire picture of the bill's effects heading into the 2018 congressional elections.
Even as the Trump administration challenged the estimate from the Congressional Budget Office, several Senate Republicans said the new analysis suggested that the party may need to rethink its plan.
Republicans "ought to slow down and get this right," Sen. Lindsey Graham, a Republican from South Carolina told reporters Monday night.
The 2018 portrait is particularly awkward. About 14 million more people would be uninsured next year under House Speaker Paul Ryan's health plan compared to the number under the ACA. Although the CBO said the measure would eventually reduce the deficit, the cost figures would still be rising through 2018, while premiums would also still be going up.
The long-term picture also poses political risk to Republicans. The number of Americans losing coverage would rise to 24 million in 2026 under the plan, bringing the U.S. uninsured rate to a record 19 percent, according to the nonpartisan CBO.
House Majority Leader Kevin McCarthy, of California, said Tuesday on Fox News that he believes the plan will pass in the House. "This is Obamacare gone — we repeal it, we repeal the taxes, and we actually make a system that works," he said.
Entire plan
House Republican leaders and the White House, who had been attacking the CBO even before it released its findings, immediately rejected the latest estimates. They said the legislation is only the first of three phases of their health care plan.
"The CBO looked at a portion of our plan but not the entire plan," Health and Human Services Secretary Tom Price told reporters outside the White House.
"We disagree strenuously with the report that was put out," said Price, who was involved in hand-picking the current CBO director in his previous role as House Budget chairman. "We believe that our plan will cover more individuals at a lower cost and give them the choices that they want, the coverage that they want for themselves and their families."
But several Senate Republicans said the new estimate shouldn't be dismissed.
"Rather than attacking the CBO as a way of moving forward, I think the prudent thing for the party to do is to look at the CBO report and see if we can address some of the concerns raised," Graham said.
Presidential setback
Sen. Susan Collins, a Republican from Maine, said the CBO "estimate that millions of Americans could lose their health insurance coverage if the House bill were to become law is cause for alarm. It should prompt the House to slow down and reconsider certain provisions of the bill." Sen. Bill Cassidy, a Louisiana Republican, added, "It doesn't look good."
Collins and Cassidy have an alternative bill they say is intended to increase coverage.
"Society is going to pay for health care whether it is through insurance or not," Cassidy, a physician himself, said. "Society will pay for it either through cost shifting to the privately insured or it will pay for it through enhanced disproportionate payments" to hospitals that treat indigent patients.
The coverage estimate is a setback for President Donald Trump, who promised that "insurance for everybody" would replace Obamacare, which used government subsidies and an expansion of Medicaid to bring coverage to 20 million people.
The president is scheduled Tuesday to speak by telephone with Anthem Inc. Chairman Joseph Swedish and Price. Anthem has expressed support for some elements of the GOP Obamacare replacement, saying in a March 9 letter that it "addresses the challenges immediately facing the individual market and will ensure more affordable health plan choices for consumers in the short term."
Republicans who have downplayed the CBO's role point out that the office overestimated by several million the number of people who would sign up for insurance through the Obamacare marketplaces.
Heed warnings
Robert Laszewski, an insurance-industry consultant who's long been critical of Obamacare, said Republicans should heed the CBO's warnings of coverage losses, even if they think they're too high.
"We're quibbling about how much pain we want to inflict here," he said.
Republicans picked the current CBO director, Keith Hall, who took over the role in April 2015.
"His vast understanding of economic and labor market policy will be invaluable to the work of CBO and the important role it will continue to play as Congress seeks to enact policies that support a healthy and growing economy," Price said after Hall was installed.
