Within their own caucuses, GOP leaders in both chambers of Congress face members who are worried about political fallout from a bill that could lead both to very large increases in the numbers of uninsured Americans, as well as to even higher price hikes for health plans that would be seen under Obamacare.
Senator Majority Leader Mitch McConnell, the Republican from Kentucky, told Reuters in an interview published Wednesday that "I don't know how we get to 50 [votes] at the moment. But that's the goal."
Republicans, who hold 52 seats in the Senate, would need 50 of their members to pass any health-care reform bill, assuming that no Democrats vote for it, and that Vice President Mike Pence would break any tie.
Leslie Dach, director of the Obamacare-defense group Protect Our Care Campaign, after release of the new analysis said, "The Congressional Budget Office confirmed yet again any health care repeal cuts coverage for millions, increases health costs for everyday people, and eliminates protections millions rely on — all to give massive tax breaks to the wealthiest Americans and insurance and drug companies."
"People across the country have rejected Republican repeal and pleaded with the Republican party to stop their partisan rush. Yet, the Senate is heading down the same repeal path the House did, working secretly behind closed doors, refusing to hold hearings and using the House repeal as a starting point," Dach said. He called on the Senate to "abandon partisan repeal of the ACA and instead work across the aisle to keep what works and fix what doesn't — not tear our health care apart."
The AHCA has been broadly unpopular among the general public. But it has been pushed by leading Republicans, including Trump, who have noted that many of their supporters have demanded that Obamacare be repealed.
Those Republicans also argue that Obamacare is failing because premiums have risen sharply, and because of the lack of competition among insurers in large parts of the United States.
Defenders of Obamacare say the law could be improved, but is not failing, and argue that it has led to historic reductions in the number of uninsured Americans, as well as to protections for people with health conditions.
The bill would make multiple, major changes to Obamacare, particularly in the way the federal government subsidizes insurance coverage for millions of Americans.
The AHCA would increase the amount of federal subsidies to young people to help them pay for their individual plan health insurance premiums, but it would reduce the amount for older adults. It also would allow those subsidies to buy health plans outside of government-run Obamacare marketplaces.
The bill also would allow insurers to charge older adults premiums that are up to five times higher than what they charge younger adults. Obamacare, in contrast, imposes a 3:1 ratio for premiums.
The AHCA would impose a premium penalty on people who do not maintain continuous health coverage.
And the bill would establish funding for states that can be used for "high-risk" individuals, or other purposes.
Read the entire CBO report on the Republican health-care law below.