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 The Congressional Budget Office, which provides official estimates
of the budget impact of proposed legislation, is expected to issue a
report as soon as Monday that will assess the healthcare legislation
put forward by Republican House of Representatives leaders.
The report could influence sentiment toward a bill already under
fire from Democrats and some Republicans, especially if it suggests
the legislation would reduce the number of Americans with health
coverage or worsen U.S. budget deficits.
Republicans have long opposed Obamacare, formally called the
Affordable Care Act, on the grounds it was government overreach and
led to higher insurance premiums. The 2010 law, Democratic President
Barack Obama’s signature legislation, provided 20 million previously
uninsured Americans with health coverage.
Trump has called Obamacare a "disaster" and made its repeal and
replacement a key campaign pledge.
Several Republican lawmakers said on Sunday the replacement bill was
unacceptable in its current form, including conservative Senator Tom
Cotton of Arkansas, who said the plan could not pass the Senate and
could put the Republican House majority at risk in 2018
congressional elections.
"I believe it would have adverse consequences for millions of
Americans and it wouldn't deliver on our promises to reduce the cost
of health insurance for Americans," Cotton said.
In a series of television interviews, White House budget director
Mick Mulvaney and top White House economic adviser Gary Cohn said
the CBO was focusing on the wrong metrics with the estimates it will
provide on the number of people who are insured. Cohn and Mulvaney
said the CBO should instead should analyze whether patients can
actually afford to go to a doctor.
"I love the folks at the CBO, they work really hard, they do, but
sometimes we ask them to do stuff they're not capable of doing, and
estimating the impact of a bill of this size probably isn't the -
isn't the best use of their time," Mulvaney told ABC's "This Week"
program.
Speaking on Fox News, Gary Cohn, director of the White House
National Economic Council, said: "We will see what the score is, in
fact in the past, the CBO score has really been meaningless."
"They've said that many more people will be insured than are
actually insured. But when we get the CBO score, we'll deal with
that," Cohn said.
'COWARDLY'
The Trump administration's criticisms of the CBO are unusual. Prior
administrations, both Republican and Democratic, steered clear of
attacking the credibility of the agency, which many lawmakers regard
as a neutral arbiter. The CBO's current director, Keith Hall, was
appointed by Republicans in 2015.
The credit rating agency Standard & Poor's has estimated 6 million
to 10 million people could lose health insurance coverage under the
Republican plan.
Senator Bernie Sanders, who ran for president in 2016 as a Democrat,
said it was "cowardly" for Republicans to proceed with a healthcare
bill without CBO estimates, telling CBS' Face the Nation show: "This
is a disgrace."
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In recent weeks, Trump administration officials and Republican
lawmakers have criticized what they said were overly optimistic
estimates from the CBO of the number of Americans who would sign up
for health insurance on government-run exchanges.
The CBO estimated in 2013 that 22 million people would be purchasing
insurance through the exchanges in 2016. Only 10.4 million were
signed up for those plans by the middle of last year, according to
Department of Health and Human Services data.
The House Republican legislation would scrap tax penalties for
Americans without health insurance, roll back an expansion of
Medicaid insurance for the poor, and replace Obamacare's
income-based subsidies with a system of fixed tax credits to help
people buy private insurance on the open market.
Cohn also disputed the notion that millions of people on Medicaid
would become uninsured as Obamacare's expansion of the program is
rolled back over a period of years. He said many of these people
would be transitioned into new private and employer-sponsored plans
that would become more affordable under the Republican plan.
House Speaker Paul Ryan, the Republican plan's top backer in
Congress, said he was "certain" the CBO would show a reduction in
the number of Americans with coverage.
"You know why? Because this isn't a government mandate," Ryan told
NBC's Meet the Press.
Conservative Republicans said, however, they could not support the
plan without significant changes. Republican Representative Jim
Jordan of Ohio, a founder of the conservative House Freedom Caucus,
said it did not go far enough to meet Republicans' promise to kill
Obamacare.
"We told them we were going to replace it with something that would
bring down the cost of insurance. That's what we told them," Jordan
told Fox News Sunday. "This legislation that the speaker's brought
forward doesn't do that."
(Reporting by David Lawder; Additional reporting by Doina Chiacu;
Editing by Grant McCool and Peter Cooney)
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