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New CBO analysis imperils GOP ObamaCare repeal

Several Senate Republicans said Monday that they would not back a procedural motion on legislation repealing and replacing ObamaCare after a Congressional Budget Office (CBO) report found the bill would leave 22 million more people without insurance over the next decade.

The findings cast serious doubt on Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellBiden to meet Monday with bipartisan lawmakers about infrastructure 100 business executives discuss how to combat new voting rules: report Arkansas governor says 'divisive' Trump attacks on GOP officials are 'unhelpful' MORE’s (R-Ky.) ability to get the measure through his chamber this week. McConnell can only afford to lose two votes, and four senators as of Monday night said they would not vote for a motion to proceed to the bill.

Sen. Susan CollinsSusan Margaret CollinsThe Hill's Morning Report - Biden assails 'epidemic' of gun violence amid SC, Texas shootings Biden-GOP infrastructure talks off to rocky start Moderate GOP senators and Biden clash at start of infrastructure debate MORE (R-Maine) wrote on Twitter after the release of the CBO report that she would vote no on the motion to advance the bill.

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“CBO says 22 million people lose insurance; Medicaid cuts hurt most vulnerable Americans; access to healthcare in rural areas threatened,” she wrote.

Sens. Rand PaulRandal (Rand) Howard PaulAlarm grows over impact of states banning trans youth treatment The Hill's 12:30 Report - Presented by ExxonMobil - World mourns the death of Prince Philip The Hill's Morning Report - Biden assails 'epidemic' of gun violence amid SC, Texas shootings MORE (R-Ky.), Mike LeeMichael (Mike) Shumway LeeOn management of Utah public lands, Biden should pursue an accountable legislative process Rubio asks MLB commissioner if he'll give up Augusta golf club membership Why some Republicans think vaccine passports will backfire on Democrats MORE (R-Utah) and Dean HellerDean Arthur HellerOn The Trail: Democrats plan to hammer Trump on Social Security, Medicare Lobbying World Democrats spend big to put Senate in play MORE (R-Nev.) also indicated they would vote against the motion without changes. The three senators, along with Sens. Ron JohnsonRonald (Ron) Harold JohnsonThe Hill's Morning Report - Biden assails 'epidemic' of gun violence amid SC, Texas shootings Trump faces test of power with early endorsements Trump endorses Rand Paul for reelection MORE (R-Wis.) and Ted CruzRafael (Ted) Edward CruzBoehner: Trump 'stepped all over their loyalty' by lying to followers The Memo: Biden's five biggest foreign policy challenges Boehner finally calls it as he sees it MORE (R-Texas), had previously announced they opposed the measure as drafted.

Even before Collins made her feelings known, the CBO analysis was raising alarm bells for centrist Republicans.

“It certainly makes me more concerned,” Sen. Bill Cassidy (R-La.) said of the analysis on CNN. “It makes me want to explore this more.”

A staff member from a GOP moderate’s office expressed frustration that the Senate bill doesn’t do substantially more than the House version to lower costs for low-income people. 

“The president said the Senate bill should be more generous, and this goes in the opposite direction,” the source said.

The CBO found that there would be 15 million more uninsured people just next year, largely because the bill repeals ObamaCare’s mandate that people buy insurance.

The number of uninsured would then rise in later years as smaller subsidies to buy private insurance and Medicaid cuts kick in.

The CBO found that lower financial assistance in the Senate bill compared with ObamaCare would make premiums unaffordable for many low-income people, and deductibles would rise as well.

“As a result, despite being eligible for premium tax credits, few low-income people would purchase any plan,” the CBO report states.

There would be 15 million fewer people enrolled in Medicaid over a decade, the CBO found, as the legislation includes deep cuts to the program.

Collins said previously that she would have trouble voting for a bill with heavy coverage losses.

Deductibles would rise, according to the CBO, as plans became less generous.

The bill also allows states to repeal ObamaCare’s requirements on what an insurance plan must cover, known as essential health benefits. That move could make certain services extremely expensive.

Nearly half of Americans would live in areas where insurance covering certain healthcare services “would become more expensive — in some cases, extremely expensive” because of the repeal of essential health benefits, the CBO found.

Premium spikes for older people were one of the most controversial areas of the House bill.

The CBO found that in the Senate bill, prices would still spike for many older people, though in some cases not quite as much as in the House bill.

For example, a 64-year-old making $26,500 would pay $6,500 in premiums per year under the Senate bill. Under ObamaCare, they pay $1,700. In the House bill, it would have been $14,600.

In a bit of good news for Republicans, the bill would result in a $321 billion deficit reduction over 10 years, the CBO found.

As with the House healthcare bill, the CBO found that premiums would initially rise under the Senate bill, before falling on average over time. This is another important finding for the GOP, which has prioritized reducing premium costs.

The report estimates premiums will increase in 2018 by 20 percent and by 10 percent in 2019. In 2020, premiums would be about 30 percent lower than under ObamaCare and 20 percent lower by 2026.

McConnell highlighted those parts of the CBO analysis in casting the report in a positive light.

“Americans need relief from the failed Obamacare law,” he said in a statement. “The Senate will soon take action on a bill that the Congressional Budget Office just confirmed will reduce the growth in premiums under Obamacare, reduce taxes on the middle class, and reduce the deficit.”

The budget savings could also provide McConnell with some negotiating leverage. There has been speculation, for example, that a $2 billion fund to help opioid addicts could be beefed up.

But as a whole, the CBO report made the GOP’s case for its bill more difficult, said Sen. Lindsey GrahamLindsey Olin GrahamMSNBC's Joy Reid pans Manchin, Sinema as the 'no progress caucus' Overnight Defense: Biden proposes 3B defense budget | Criticism comes in from left and right | Pentagon moves toward new screening for extremists Biden defense budget criticized by Republicans, progressives alike MORE (R-S.C.).

“If you were on the fence, if you were looking at this as a political vote, the CBO score didn’t help you,” said Graham, who nonetheless is leaning in favor of the bill himself.

Alexander Bolton, Jessie Hellmann, Rachel Roubein and Nathaniel Weixel contributed.