House Schedules Vote On Health Care Bill; CBO Revises Cost

Republicans in the House scheduled a do-or-die vote late Friday afternoon for the American Health Care Act, as the Congressional Budget Office released an updated report saying amendments to the bill would cost billions more without increasing coverage.

The CBO said the AHCA's amendments -- made to appease Republicans who said they wouldn't vote for the bill in its original form -- would decrease the federal deficit by $150 billion in a decade. The original bill was projected to cut the deficit by $337 billion. The CBO said the amendments would also not increase coverage, meaning there would still be 24 million fewer people with healthcare by 2026 if signed into law.

The CBO also said the amended AHCA's impact on health insurance premiums would be about the same as the original version. The CBO estimated average premiums for individual plans would increase up to 20 percent over the next two years, but by 2026, premiums would be 10 percent lower than they would be under President Barack Obama's signature healthcare law, the Affordable Care Act, or Obamacare.

In short, the CBO said the AHCA's amendments do little other than to cost the federal government more money.

In order to be approved and sent to the Senate, the AHCA needs 215 of the 237 Republican votes in the House. In other words, House Republicans can only afford to lose 21 votes. Freedom Caucus voters could easily help surpass that threshold, but have been at odds with Republican leadership since the AHCA, or H.R. 1628, was first announced.

Republicans were unable to secure enough votes Thursday to pass the bill and delayed the vote until Friday. The decision to go forward Friday came at Trump's insistence, after the president and House Speaker Paul Ryan essentially told GOP voters to take the new plan as is, or leave it, White House Budget Director Mick Mulvaney said.

If the vote fails, Trump purportedly said he will leave the Affordable Care Act in place and move on to other matters. Rep. Chris Collins, R-N.Y., and Mulvaney both said Trump is done negotiating on healthcare.

Some conservatives have panned the package because they say it doesn't go far enough in repealing the ACA. President Donald Trump has courted holdouts among Republicans heavily this week, warning them they might eventually lose control of Congress if they don't approve the bill.

Trump this week visited Capitol Hill in an attempt to persuade the House Republicans to pass the AHCA.

"After seven horrible years of Obamacare (skyrocketing premiums & deductibles, bad healthcare), this is finally your chance for a great plan!" Trump tweeted on Friday. "The irony is that the Freedom Caucus, which is very pro-life and against Planned Parenthood, allows P.P. to continue if they stop this plan!"

The GOP plan shares some similarities with the ACA, like requiring insurers to cover people with pre-existing conditions and providing coverage subsidies. Young adults would also be allowed to remain on their parents' insurance until the age of 26.

Unlike the former president's signature law, though, the AHCA would spend less on subsidies and reduce Medicaid spending -- using those savings to eliminate taxes imposed by the ACA on wealthier Americans and medical companies.

In an effort to win over resisting conservatives, GOP leadership made the changes to grant individual states more flexibility on Medicaid, and eliminate ACA taxes for uninsured persons this year instead of the original 2018 target date.

To please moderates, the revisions also said Medicaid allotments for older and disabled beneficiaries would increase faster than inflation, and allowed the Senate to craft more generous tax credits for people between the ages of 50 and 64.

The CBO said those changes would only lead to less savings and cause little other effect.

"CBO estimates that enacting H.R. 1628, with the proposed amendments, would save $186 billion less over that period," the CBO said in a statement. "The legislation's impact on health insurance premiums would be approximately the same as estimated for the previous version."

Doug G. Ware contributed to this report.