WASHINGTON — The White House and Republican leaders in Congress scrambled on Tuesday to shore up support for their health care bill as critics went on the attack over new estimates that 14 million people would lose insurance coverage in the first year alone.
The findings from the Congressional Budget Office handed fresh ammunition to Democratic opponents of the GOP drive to repeal and replace former President Barack Obama's health care law. The new figures, which estimated that 24 million people would lose insurance over a decade, also appeared to strengthen pockets of conservative resistance to the bill and rattle nerves among rank-and-file Republicans.
With Washington blanketed in a rare March snow, congressional GOP leaders and top aides to President Donald Trump got to work trying to salvage the legislation, which they hope to push through the House next week and the Senate the week after that. Trump has promised to sign the bill, fulfilling seven years of GOP promises to undo "Obamacare," even though the legislation breaks the president's own past promises to safeguard Medicaid and provide health insurance for all.
"We think we've created a system that saves money and allows more people to get affordable health care," Mick Mulvaney, the White House budget director, said Tuesday morning on MSNBC. Mulvaney disputed the CBO findings about how many people would lose coverage, while highlighting the agency's conclusions that the GOP bill would reduce the deficit by $337 billion over a decade and lower insurance premiums by around 10 percent starting in 2020. The premiums reduction would come only after they sharply rose in 2018 and 2019.
The GOP legislation would use tax credits to help consumers buy health coverage, expand health savings accounts, phase out an expansion of Medicaid and cap that program for the future, end some requirements for health plans under Obama's law, and scrap a number of taxes.
Republicans say they are not trying to achieve the widespread coverage that Democrats aimed for by including penalties in the Affordable Care Act for people who weren't covered. Instead Republicans would eliminate that mandate, and their buzzword is "access" to affordable coverage for people who want it.
"You sit there and talk about coverage, but coverage is not the end. People don't get better with coverage," Mulvaney said.
Angry Democrats, united against the GOP bill, scoffed at such claims.
"Trumpcare would be a nightmare for the American people," Senate Minority Leader Chuck Schumer of New York said at a news conference at the Capitol with House Minority Leader Nancy Pelosi of California.
Criticism also is coming from conservatives who threaten to foil GOP leaders' plans of swift passage of the legislation before Easter, when Congress is scheduled to go on a two-week recess that could expose lawmakers to town hall fury.
Ohio Republican Rep. Jim Jordan, a member of the Freedom Caucus and one of the most outspoken critics of the bill, reiterated Tuesday that he and other conservatives have been working with the White House on changes to the Republican health plan. They have dubbed the bill "Obamacare Lite," saying it doesn't fully repeal the Affordable Care Act and installs a new but similar system of tax credits that they deride as a new entitlement.
"This bill doesn't unite Republicans. This bill doesn't bring down the cost of premiums," Jordan told Fox News' "Fox and Friends." ''I don't think it's going to accomplish what we told the voters we were going to do."
House Speaker Paul Ryan has confidently predicted the bill will have the support needed to pass on the House floor next week, but Mulvaney seemed to suggest more work is needed to get to the 216 votes that will be required. He said negotiations are still going on as conservative lawmakers push changes to the bill.
"I don't think we're in a position to start counting votes until we know what that bill looks like," Mulvaney said.
The CBO is widely respected but doesn't have a perfect track record, including estimating that Obamacare would cover more people than it has. The office's estimates are relied upon by politicians from all sides, though often attacked when unfavorable.
Senators are just beginning to absorb the CBO findings and were to meet at the Capitol Tuesday with Health and Human Services Secretary Tom Price.
"It's awful. It has to be a concern," Sen. Bill Cassidy, R-La., said of the budget office findings. "President Trump said he wanted as many people covered as under Obamacare."
"At the end of the day, we should pause and try to improve the product in light of the CBO analysis rather than just rejecting it," said Sen. Lindsey Graham, R-S.C.
All along Republican leaders have assumed that once it comes time to vote, few if any Republicans will dare vote "no" on the repeal and replacement of "Obamacare" that their party has been promising for seven years. They are relying on Trump's popularity with conservative voters to close the deal, and Trump on Monday announced he would be traveling to Kentucky for a rally early next week.
Associated Press writers Matthew Daly, Alan Fram, Stephen Ohlemacher, Mary Clare Jalonick, Richard Lardner and Andrew Taylor contributed to this report.