WASHINGTON — With the survival of the Republican health care plan already teetering on the brink, Republican senators are expressing new reservations in the wake of a Congressional Budget Office report that tens of millions will be uninsured in a decade under the new plan.
Republicans can only afford to lose two of their 52 senators to pass the American Health Care Act through the Senate — and even then they would rely on a special reconciliation process and Vice President Mike Pence to break the tie. Already, Senators Mike Lee and Rand Paul have come out hard against the AHCA, leaving no margin for error.
But after a new CBO report projected Monday that the plan will lead to 24 million more uninsured people in 2026 than Obamacare would have, some Republicans are calling for the administration and congressional leadership to pump the brakes.
“The good news is it lowers premium costs and helps the deficit. But, at the end of the day, we should pause and try to improve the product … and figure out why the CBO thinks we’re going to lose that many people in terms of coverage," Sen. Lindsey Graham said Monday.
Graham echoed Arkansas Sen. Tom Cotton, who called for some time to work on the health care bill, which is currently making its way through the House, over the weekend, before the CBO's projections came through.
"I’m afraid that [the bill] could make it worse in some ways, that insurance rates would continue to go up and that Americans would have even less control and less choice over their healthcare systems," Cotton said on ABC Sunday.
"That’s why I say that it’s time to take a pause, take stock of how we got to where we are."
The CBO projects the number of uninsured people would be 14 million higher under the AHCA than under Obamacare in 2018. That number grows to 24 million by 2026.
Republicans are also worried about the CBO's projection that premiums will rise by 15-20% above the status quo by 2020, the year of the next presidential election, and after a 2018 midterm election — in which every House member and one-third of the Senate will be up for reelection — before dropping off to be 10% cheaper than Obamacare by 2026.
"Of course it's concerning. I mean, I try and avoid hyperbole and adjectives [...] but still it's just, shall we say, concerning," said Louisiana Sen. Bill Cassidy, who is also a physician and released a separate health care bill earlier this year.
The Trump administration has so far strongly rejected the CBO report. Health and Human Services Secretary Tom Price called its projections "virtually impossible" and "just not believable."
Meanwhile, House Republican leadership pointed to the positives in the CBO report, focusing largely on its calculation that the new health care bill will save money and that premiums will go down — just not for a few years. House Speaker Paul Ryan and others praised those aspects of the report Monday, while saying that the AHCA was merely step one of their plan to improve health care costs.
But Graham urged fellow Republicans to consider the report and how to address the problems it raises.
"We like the CBO when they agree with us. When they don't, they're a bunch of losers," he said.
Graham said that if the report is even "half-right" there is cause for concern and reason to improve the bill.
Sen. John McCain of Arizona said he was worried about the impact the AHCA will have on the Medicaid rolls in his state. Arizona is one of the states that expanded Medicaid eligibility under Obamacare. That expansion would be frozen and gradually rolled back under the Republican plan. Four other Republican senators from states that expanded Medicaid wrote a letter to Senate Majority Leader Mitch McConnell raising concerns about the future of the program under AHCA earlier this month as well.
The CBO report projects an $880 billion drop in Medicaid spending over the next decade if the AHCA is passed.
"CBO was wildly wrong on the initial estimates of Obamacare so — but you always take into consideration their predictions," said McCain.
CORRECTION
The CBO projects that the GOP health care bill would lead to an $880 billion decrease in Medicaid spending over the next decade. An earlier version of this story incorrectly said $880 million.