WASHINGTON — The House Republican plan to repeal and replace the Affordable Care Act would raise the number of people without health insurance by 24 million within a decade, but would trim $337 billion from the federal deficit over that time, the nonpartisan Congressional Budget Office said on Monday.
Republicans had been bracing for what was almost certain to be a bleak accounting of the legislation’s projected effects. The American Health Care Act, as Republicans call their bill, was already facing widespread criticism from providers of health care, some conservatives, and a united Democratic Party. The numbers released Monday will make only it more difficult for Republicans to explain why their legislation would bring positive change to the country’s health care system.
In recent days, Democrats had criticized Republicans for pushing the health care bill through two House committees last week before the Congressional Budget Office had weighed in, saying it was irresponsible to begin considering legislation without a firm grip on its potential costs and ramifications.
“Republicans are racing their disastrous health bill forward before the C.B.O. can expose its consequences to the American people, but they can’t hide from the facts forever,” the House Democratic leader, Representative Nancy Pelosi of California, said last week.
The C.B.O. produces a variety of budget and economic analyses, including deficit projections, legislative options for lawmakers confronting the nation’s most vexing problems, and cost estimates for legislation. Its director, Keith Hall, was appointed in 2015 by congressional Republicans, and it has maintained respect for its objective analysis.
But with an unfavorable analysis expected, Republicans from the White House to Capitol Hill began to undermine the credibility of the budget office’s numbers last week and kept it up through the weekend.
“If the C.B.O. was right about Obamacare to begin with, there’d be 8 million more people on Obamacare today than there actually are,” President Trump’s budget director, Mick Mulvaney, said Sunday on ABC’s “This Week.” He added, “Sometimes we ask them to do stuff they’re not capable of doing.”
The number of people who have signed up for insurance through the health law’s exchanges is lower than expected, in part because employers did not drop coverage to the extent that had been anticipated. In addition, the Supreme Court ruled that states could not be compelled to expand Medicaid — and many Republican-led states opted not to do so.
The House Republican legislation, which was released last week, would repeal major parts of President Barack Obama’s health care law. It would scrap the income-based tax credits that helped people pay for coverage, end the penalty for people who do not have health insurance and phase out the expansion of Medicaid that has brought coverage to millions of people.
Republicans would provide a new tax credit based on age that would help people buy insurance on the individual market. While people would not face a penalty for not buying insurance, Republicans would put in place a new provision to encourage continuous coverage: People would face a 30 percent surcharge in their premiums if they signed up for insurance after having gone without it for about two months or more.
But the bill would save the government $337 billion over 10 years, a big win for conservatives that could ease pressure on the legislation from the right. Under budgeting rules that Republicans are using to rush through a bill to repeal the health care law, the measure was supposed to trim the deficit at least $2 billion over 10 years. Otherwise, Democrats in the Senate could move to filibuster it.
In an interview last week with the radio host Hugh Hewitt, the House speaker, Paul D. Ryan, played down the significance of the forthcoming coverage estimate. He said the goal of Republicans was not “to win some coverage beauty contest” or “to show a pretty piece of paper that says we’re mandating great things for Americans” with their health bill.
“If the government says, ‘Thou shall buy our health insurance,’ the government estimates are going to say people will comply and it will happen,” Mr. Ryan said. “And when you replace that with, ‘We’re going to have a free market and you buy what you want to buy,’ they’re going to say not nearly as many people are going to do that.”
Before the C.B.O. assessment was released, Mr. Trump lauded the Republican health plan Monday at the beginning of a discussion with people the White House described as “victims” of the Affordable Care Act.
The president said the Republican plan would provide “more choices, far more choices, at lower cost.”
“Americans should pick the plan they want,” he said. “Now they’ll be able to pick the plan they want. They’ll be able to pick the doctor they want.”
Mr. Trump predicted that if the Republican plan gets enacted, “you’ll see rates go down, down, down, and you’ll see plans go up, up, up.” He said it would be “a thing of beauty.”
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