After months of work, Speaker Paul Ryan enjoyed a victory this week when he was able to convince enough of his fellow Republicans in the House to vote for a GOP bill to repeal and replace Obamacare.
The original bill, known as the American Health Care Act, has been amended three times since it was first unveiled. The nonpartisan Congressional Budget Office scored the initial bill and the first amendment. But since then, the bill has gone through two more substantial changes, one to appease conservatives and one to appease moderates.
A March 13 review of the bill by the nonpartisan Congressional Budget Office found the AHCA would result in14 million fewer people with insurance by next year and 24 million by 2026 compared to Obamacare.
A second CBO review on March 23, after the first minor "manager's amendments" were made, found the same figures for the uninsured.
There has been no review since then, despite the two other rounds of amendments to the bill — including the changes to please the conservatives, which could enable states to allow insurance companies to raise prices on people with pre-existing conditions.
The events of the last week all happened very quickly. After the bill was amended a second time on Wednesday to appeal to moderates, it was rushed to a vote on Thursday without any additional CBO reviews or committee hearings.
It passed the House by a razor-thin margin, with 20 Republicans joining all the Democrats in voting against it.
Even Republicans noted the final version of the bill had not been scored by the CBO, nor debated for very long.
Which is what made this tweet from Ryan spokeswoman AshLee Strong on Saturday so gobsmackingly deceptive.
Strong is technically correct that a bill known as the AHCA was put online a month ago, considered by four committees, and scored twice by the CBO.
But that certainly wasn't the final version of the bill, which had undergone some rather massive changes by that point.
Reached by email on Saturday, Strong stuck to her claim that the AHCA had been scored twice by the CBO. "Only narrow changes have been made since the last score," she wrote.
She also said the bill will be scored again by the CBO when it is in the Senate (where it is likely to be significantly altered).
"An updated CBO score is required before the Senate can take up the reconciliation bill per the Senate rules to ensure it complies with the requisite savings. Timing of that score is a question for CBO," Strong wrote in the email to BuzzFeed News. "This isn’t the final bill or the final vote. It’s only the first step in the legislative process."
But the argument that the original bill has only undergone "narrow changes" is also false.
To win the support of the ultra-conservative Freedom Caucus, the new bill was altered significantly at the end of last month.
The bill was changed to allow states to waive Obamacare rules such as the ban on charging people with pre-existing conditions higher premiums and essential health benefits, or the minimum requirements for what health insurance plans must cover.