During the debate over the House Republican plan, Sen. Susan Collins (R-Maine) made clear she was unimpressed with the GOP proposal. Any bill resulting "in 23 million people losing coverage is not a bill that I can support," the Maine Republican said in March.
OK, how about 22 million?
The Senate health care bill would insure 22 million fewer people after a decade than current law, according to an analysis by the non-partisan Congressional Budget Office.It would save $321 billion in the same period overall by spending $1 trillion less on health care and using the savings to repeal the Affordable Care Act's taxes, which primarily affect wealthy individuals and medical companies.
The CBO's full report is online here. Note that the impact imposed on the nation would be felt almost immediately -- there would be 15 million more uninsured Americans next year, which happens to be an election year, according to the non-partisan office's estimate -- before getting worse in the years that follow.
Complicating matters, the CBO score added, "By 2026, among people under age 65, enrollment in Medicaid would fall by about 16 percent and an estimated 49 million people would be uninsured, compared with 28 million who would lack insurance that year under current law."
I should concede that this report is quite a bit worse than I thought it'd be. Senate Republican leaders worked fairly closely with CBO officials while writing their secret legislation, getting periodic updates. Indeed, it's one of the reasons the CBO score, which would ordinarily take two weeks, was turned around so quickly.
With this in mind, I figured Senate Majority Leader Mitch McConnell's (R-Ky.) office would carefully game the system, and tweak his blueprint in such a way that the numbers would look less awful. But if that was the plan, it failed spectacularly: the CBO's findings are, or at least should be, a punch to the gut of proponents of Senate Republicans' legislation.
Donald Trump has gone out of his way lately to say he wants to see a health care bill "with heart." By any sensible standard, it's now painfully obvious that the GOP legislation fails this simple test.
Republicans like to pretend their bill wouldn't cut Medicaid, but the CBO report discredits the argument. Republicans like to argue that the Affordable Care Act doesn't cover enough Americans, and the CBO report shows that the GOP's alternative would make matters vastly worse. Republicans like to argue that the consumer costs are too high under the ACA, and the CBO report points to much higher costs for the poor, who'll be left with worse coverage.
For Senate Republicans who remain on the fence, unsure whether to prioritize party loyalty over health security, the Congressional Budget Office has helped answer the question in rather dramatic fashion.
What's unclear is whether GOP senators -- which is to say, at least 50 of them -- will care. At a certain level, lawmakers in both parties have known that the Republican plan would hurt a significant chunk of the population, and most GOP senators, as of earlier this afternoon, seemed ready to vote for the bill anyway. There's no reason to assume the Senate majority is guided in any meaningful way by elements such as evidence and independent data.
That said, given the handful of Republicans who've said they're uncertain about their party's plan, the odds of this bill passing the Senate this week just got worse.