Revised Republican health care bill is more costly, but doesn't insure more people

Recent revisions to the Republican health care bill means it would cost more, and still leave 24 million fewer people insured by 2026, new estimates from the Congressional Budget Office show.

The legislation to repeal major portions of Obamacare would reduce federal deficits by $150 billion over 10 years, according to the revised estimates. The original bill would have lowered the deficits by $337 billion.
The new score comes as House Republicans frantically try to shore up support for the bill. House leaders were forced to postpone voting on the measure Thursday, as conservative members continued to oppose it.

The agency revised its figures to reflect amendments made to the bill that were announced on Monday. The new numbers do not take into account a deal underway to woo House conservatives to support the measure.
Though the bill would be more costly, it would still leave 24 million fewer people insured than under current law. Some 52 million people would be uninsured in 2026 under the GOP legislation, compared to 28 million if Obamacare continued -- the same as the prior estimate.

Also, it did not change the agency's outlook on premiums, which it expects would be higher initially, but then roughly 10% lower than Obamacare by 2026.

The initial score sparked outrage and concern that so many people would be left uninsured. Under Obamacare, the uninsured rate fell to the lowest level on record.

Much of the added costs stem from letting taxpayers deduct more of their medical expenses and repealing a slew of Obamacare taxes -- include two levied on higher-income Americans -- a year earlier.

The House purposely made legislation more expensive so the Senate could provide more generous tax credits to older consumers shopping in the individual market. House GOP lawmakers have come under fire because their bill would cause premiums to spike for those in their 50s and early 60s.

Funding for the additional tax credits -- which will be crafted by the Senate -- would come by allowing taxpayers to deduct medical expenses that exceed 5.8% of their income, according to a House staffer. The change would give the Senate $90 billion over 10 years to work with, the CBO found.

The original GOP bill set that threshold at 7.5%. Under Obamacare, taxpayers could only deduct medical costs greater than 10% of their income.

Other amendments to the original bill were mainly aimed at toughening Medicaid rules for adults, but making some allowances for the disabled and elderly covered by the program. Overall, that makes the bill more expensive, increasing the cost by $41 billion over a decade.

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House set to vote on GOP health care bill Friday morning

The House will vote on the Republican-backed American Health Care Act (AHCA) at 10 a.m. Friday after Thursday evening's planned House vote was delayed.

House and White House leadership held a closed-door meeting Capitol Hill Thursday night to discuss the bill. White House Chief of Staff Reince Priebus and Chief Strategist Steve Bannon briefly attended. Priebus told ABC News that he was "still feeling positive" but that there was "a lot of work to do." Speaker of the House Paul Ryan, Office of Management and Budget (OMB) Secretary Mick Mulvaney and House Majority Leader Rep. Kevin McCarthy, R-California, were also in attendance.

The AHCA vote was postponed this afternoon as the party struggled to collect the votes needed to ensure its passage.

But the White House said it is "confident" the bill will pass Friday. "Debate will commence tonight as planned and the vote will be in the morning to avoid voting at 3 a.m.," White House deputy press secretary Sarah Huckabee Sanders said.

"We feel this should be done in the light of day, not in the wee hours of the night and we are confident the bill will pass in the morning."

President Trump had made his last-minute sales pitch to conservative House Freedom Caucus members at the White House earlier in the day. After the meeting, however, caucus members said they hadn't reached a point where they could support the AHCA in its current form.

The president and caucus members discussed options and were "trying to get creative," caucus Chairman Mark Meadows, R-North Carolina, told ABC News.

“We are certainly trying to get to yes,” Meadows told reporters on the Hill today before the vote postponement. “But, indeed, we've made very reasonable requests and we are hopeful that those reasonable requests will be listened to and, ultimately, agreed to.”

Spicer had earlier called the meeting a “positive step” and said the White House was “very, very pleased with the direction” of the negotiations.

He also dismissed characterizations of the meeting as attempts to strike a deal.

“I think some of them stood up and said, ‘Mr. President, we're with you.’ I think a lot of them said, ‘We're going to go back and think about it.’ The meeting didn't conclude by saying, ‘Do we have a deal?’ That’s not why we have it,” Spicer said. “This was a discussion that the president continues to have.”

Some House Republicans have grown frustrated with the demands of their colleagues in the Freedom Caucus.

"Two groups that don't represent even the majority of the Republican conference have been given every opportunity to have multiple conversations with the president and the leadership," Rep Bradley Byrne, R-Alabama, said. "At some point you've got to say, 'That's it.' And we're at that point."

Despite Wednesday’s late-night negotiations and personal pitches from President Trump, the list of "no" votes against the AHCA appeared to still stand.

At least 32 Republicans had said they would oppose the bill, according to ABC News’ latest whip count. The GOP needs 216 votes for a simple majority to pass the bill in the House, so they can afford to lose 21 votes for passage.

Where the Republican health care bill stands right now

Obamacare repeal isn’t dead. Yet.

But the drive by House Speaker Paul Ryan and President Donald Trump for rapid passage of a repeal-and-replace bill appears to be on life support as of Thursday afternoon. Talks between Republican leadership and the House Freedom Caucus early in the day broke down, and the planned late night vote on the American Health Care Act was canceled.

Then, in the evening, President Trump has sent OMB director Mick Mulvaney to Congress to announce that the White House is cutting off negotiations and wants a vote on the AHCA tomorrow. Mulvaney said that if Republicans vote down the bill, Trump would simply move on to other issues and the holdouts would be responsible for leaving Obamacare in place, according to Politico’s Jake Sherman.

Congressional Republican leaders don’t seem to love this plan. Jonathan Swan of Axios reports that they “think they're still short on the vote count,” and fear that “if the bill comes to the floor with less than the required number, the vote will collapse on them.” But Trump wants it, so it is apparently happening, even though no deal has yet been reached with either holdout group. What could go wrong?

Nothing is over until it’s over, of course. White House press secretary Sean Spicer struck a defiant tone at Thursday’s press briefing, saying, “It’s going to pass, so that’s it,” while refusing to entertain any hypotheticals about backup plans. And indeed, it’s entirely possible that conservative dissidents will come back to the table and the repeal train will get moving again.

But Spicer also appeared to be laying the groundwork to distance the White House from possible failure, observing that “at the end of the day we can’t make people vote.”

Rep. Mark Meadows (R-NC), a key leader of the Freedom Caucus, did promise late Thursday that “we are going to get to the finish line.”

But for now at least, the process seems to have gone off the rails.

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