That would be a terrible outcome. There is nothing skinny about it, because the measure would leave 16 million more people without insurance, according to the Congressional Budget Office. That is four-fifths of the 20 million who gained health insurance under the A.C.A.. In addition, people who continue to purchase their own insurance and earn too much money to qualify for federal subsidies could see premiums jump 20 percent if they could buy comprehensive policies at all. Forget the Republican vow to save the country from a “collapsing” Obamacare. If this bill becomes law, it would magnify weaknesses in Obamacare and leave millions of individuals and families worse off.

Its core is elimination of the A.C.A. requirement that individuals buy insurance or pay a penalty. This is meant to prevent people from buying policies only when they need care, which would lead insurers to charge more, or bar policies for individuals so that the very sick would not be their only customers. With higher prices, fewer people would buy coverage, creating a “death spiral.” No wonder America’s Health Insurance Plans and the American Medical Association oppose the plan, as do 10 governors from both parties who sent Senate leaders a letter.

The conference option is also dreadful because lawmakers could use it to cook up a bill with big cuts to Medicaid, which the Senate rejected this week. That bill would be put to a vote in both chambers, with limited debate, under pressure by congressional leaders and President Trump to vote yes. They have already used underhanded tactics. On Wednesday, Interior Secretary Ryan Zinke told the two senators from Alaska, Dan Sullivan and Lisa Murkowski, that Ms. Murkowski’s vote against starting debate on health care had “put Alaska’s future with the administration in jeopardy,” according to the Alaska Dispatch News. Health and Human Services Secretary Tom Price has been using Obamacare money for a propaganda campaign against it.

This much is clear: The Republican mission to destroy Obamacare has become a farce, albeit one that may yet harm the health of millions of Americans.