But now the other shoe has dropped: Released Wednesday, the CBO’s scoring of the new bill finds that a few cosmetic tweaks don’t change the fact that the AHCA remains a breathtakingly cruel bill.

The headline figures are bad enough: The CBO projects that 14 million more people will be without health insurance by 2018, 19 million by 2020 and 23 million by 2026. The details make the bill look even worse. It would slash Medicaid spending by $834 billion, with 14 million people losing Medicaid coverage. Because states would be allowed to waive key provisions instituted by Obamacare, those states would eventually see sick people priced out of the market. Low-income seniors would be devastated by premium increases as high as 800 percent (while higher-income Americans would have decreased premiums). “One-sixth of the population resides in areas” where the AHCA would disturb insurance markets, the CBO projects. The cost of maternity care “could increase by thousands of dollars.” Because the bill reduces the scope of the benefits that plans would be required to include, even those on employer plans could face substantial increases in out-of-pocket costs.

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And the AHCA inflicts all this pain while simultaneously giving billions of dollars in tax breaks to the wealthiest Americans.

The AHCA is cruel. There is no other word for it. If the law is enacted, people will die because of it.